Very interesting results of the RFN Poll of the Week regarding different opinions regarding managing the potassium bath in a patient with hyperkalemia!
Of the options give, there was a near three-way split between the first three answers (giving a 1K bath, giving a 2K bath, or a giving a 1K bath and then changing to a 2K bath after one hour). In my opinion, this speaks to the overall lack of data describing what one should do in managing hyperkalemia during dialysis! I would also imagine that an individual's choice would be highly influenced as to where they trained or what the practice patterns are at their individual hospitals.
Personally, I was taught the "rule of 7's"--the patient's serum K plus their dialysate bath K should equal approximately 7. Unfortunately this tends to break down at higher potassium levels.
I think the ideal way to manage this problem is a step approach (3/2/1 etc) which will prevent a sudden change of K gradient to avoid potential dangerious cardiac issues
ReplyDeleteI like the rule of 7's.. never heard that one.
ReplyDeleteGreat job with the changes on the blog.
Keep up the good work!
SP
I think the important factor for determining K bath in this case is patient's compliance to the diet (NO MORE BANANAS DISHES).If this patient is known non-compliant I will tend to use lower K bath.
ReplyDeleteThanks again and again for this informative blog.Keep up the good work.
AK