Exemplar teaching-
Hyperkalemia related to Chronic Renal Failure
Patho- Many causes
● Decreased renal excretion, which is cause of decreased glomerular filtration rate which
is a common symptom of CRF accumulates potassium in the kidneys. 80% of the
potassium is excreted daily and that doesn’t happen when the body is in Chronic Renal
Failure
● In early stages of chronic renal failure there can be significant damage to the kidneys
without signs or symptoms. The patho isn’t clearly understood yet but the damage to the
kidneys is thought to be caused by prolonged acute inflammation that is NOT organ
specific and can have subtle SYSTEMIC manifestations/issues.
● 5 stages of CRF and hyperkalemia occurs in stages 4 and 5
● Hyperkalemia in CRF is way more common in pts taking RAAS inhibitors
● Its also due to metabolic acidosis,excessive potassium intake orally and intravenously
Commonly seen in patients with
● Untreated kidney disease
● Diabetic Nephropathy-
● Hypertensive nephrosclerosis-
● Chronic glomerulonephritis
● Chronic pyelonephritis
● Renal aging- slows down the kidneys and can result in hyperkalemia
Education-
Meet with a renal dietitian- its important to restrict potassium in this diet
dialysis - helps waste products that the kidneys can't which can control hyperkalemia
Assess limited fluid status and identify potential sources of imbalance
Explain to family why they are fluid restricted
Report any weight changes
Keep and eye on high potassium lab values
Hyperkalemia related to Chronic Renal Failure
Patho- Many causes
● Decreased renal excretion, which is cause of decreased glomerular filtration rate which
is a common symptom of CRF accumulates potassium in the kidneys. 80% of the
potassium is excreted daily and that doesn’t happen when the body is in Chronic Renal
Failure
● In early stages of chronic renal failure there can be significant damage to the kidneys
without signs or symptoms. The patho isn’t clearly understood yet but the damage to the
kidneys is thought to be caused by prolonged acute inflammation that is NOT organ
specific and can have subtle SYSTEMIC manifestations/issues.
● 5 stages of CRF and hyperkalemia occurs in stages 4 and 5
● Hyperkalemia in CRF is way more common in pts taking RAAS inhibitors
● Its also due to metabolic acidosis,excessive potassium intake orally and intravenously
Commonly seen in patients with
● Untreated kidney disease
● Diabetic Nephropathy-
● Hypertensive nephrosclerosis-
● Chronic glomerulonephritis
● Chronic pyelonephritis
● Renal aging- slows down the kidneys and can result in hyperkalemia
Education-
Meet with a renal dietitian- its important to restrict potassium in this diet
dialysis - helps waste products that the kidneys can't which can control hyperkalemia
Assess limited fluid status and identify potential sources of imbalance
Explain to family why they are fluid restricted
Report any weight changes
Keep and eye on high potassium lab values
