What are the treatment options for severe hyperkalemia?

Updated: Apr 09, 2020
  • Author: Eleanor Lederer, MD, FASN; Chief Editor: Vecihi Batuman, MD, FASN  more...
  • Print

In patients with severe hyperkalemia, treatment is as follows:

  • IV calcium to ameliorate cardiac toxicity, if present

  • Identify and remove sources of potassium intake

  • IV glucose and insulin infusion to enhance potassium uptake by cells

  • Correct severe metabolic acidosis with sodium bicarbonate

  • Consider beta-adrenergic agonist therapy (eg, nebulized albuterol, 10 mg, administered by a respiratory therapist); preferred over alkali therapy in patients with renal failure

  • Increase potassium excretion by administering diuretics or gastrointestinal cation-exchange medications

  • Emergency dialysis for patients with potentially lethal hyperkalemia that is unresponsive to more conservative measures or with complete renal failure

Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!