Patient handout

Hyperkalemia (syndrome aggregator)

PRODUCTION

1. Your condition

This handout is for hyperkalemia (syndrome aggregator). Your care team identified this based on: serum k+ ≥5.5 mmol/l (mild) / ≥6.0 (moderate) / ≥6.5 or ecg (severe).

Other reasons your team may use this plan: peaked t waves / pr prolongation / qrs widening on ecg; muscle weakness / paralysis / paresthesias.

2. Your medications

Take these medications exactly as prescribed. Do not stop or change a dose without talking to your provider.

Medication	Starting dose	How	When	What it does
discontinue_offenders	—	—	—	Review ACEi/ARB/MRA/spironolactone/heparin/TMP/NSAID — Clase KDIGO 2020
patiromer	8.4 g PO daily	PO	daily, titrate to 25.2 g	OPAL-HK (Weir 2015); permits RAS continuation

Plan: Severity-tiered hyperkalemia management (UK Renal Association 2023 + ESC 2024)

4. When to seek emergency care

Call 911 or go to the nearest emergency room right away if you have:

K >6.5 OR ECG changes (peaked T, PR, QRS widening, sine) — UK Renal Association 2023(life-threatening)
K 6.0-6.4 with no ECG changes — UK Renal Association 2023
K not declining within 60 min of shift therapy — KDIGO 2024(life-threatening)
Cardiac arrest in patient with known/suspected hyperkalemia (ESRD missed dialysis, severe AKI, crush, DKA): asystole / PEA / wide-complex bradyarrhythmia — ERC 2021(life-threatening)
Acute digoxin toxicity with K >5.0 (a poor-prognostic marker in chronic toxicity per Bismuth) — AHA 2020; Levine Clin Toxicol 2011(life-threatening)

5. Follow-up

Outpatient BMP within 1 week if RAASi resumed — KDIGO 2024; finerenone 2/4-week cadence — FINEARTS-HF (Solomon 2024); dietary K education; reconcile contributing meds — Clase KDIGO 2020

6. Sources

Guideline: UK Renal Association Clinical Practice Guideline: Treatment of Acute Hyperkalaemia in Adults 2023 v2.0 + KDIGO 2024 CKD (hyperkalemia management) + 2023 ACC/AHA/HFSA HF Focused Update + 2024 ESC Hyperkalemia Consensus + ERC 2021 Cardiac Arrest in Special Circumstances