Dialysate potassium concentration: Should mass balance trump electrophysiology?

Seminars in Dialysis
Patrick H Pun

Abstract

Nephrologists are faced with a difficult dilemma in choosing the ideal dialysis prescription to maintain neutral potassium mass balance. Should potassium mass balance goals prioritize the normalization of serum potassium levels using low potassium dialysate at the expense of provoking intradialytic arrhythmias, or should mass balance goals favor permissive hyperkalemia using higher dialysate potassium to avoid rapid intradialytic fluxes at the risk of more interdialytic arrhythmias? This review examines the factors that determine potassium mass balance among HD patients, the relationships between serum and dialysate potassium levels and outcomes, and concludes by examining currently available approaches to reducing risk of arrhythmias while managing potassium mass balance.

References

Feb 1, 1989·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·S HouM Beach
Jan 1, 1986·American Journal of Nephrology·R A ShermanR P Eisinger
Jan 1, 1980·Kidney International·R A DeFronzo
Aug 1, 1997·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·A BlumbergJ Müller-Brand
Feb 24, 2001·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·C ZehnderD Schneditz
Jun 26, 2001·Kidney International·J A KarnikG M Chertow
Feb 12, 2002·The American Journal of Medicine·Greg A KnollKevin D Burns
Jun 5, 2002·The Journal of Clinical Hypertension·D A SicaM Epstein
Feb 3, 2005·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Ricardo M HeguilénAmelia R Bernasconi
Mar 24, 2005·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Michele BuemiDiana Teti
Apr 25, 2006·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Mohammed O KaisarDavid W Johnson
May 5, 2006·Kidney International·A J BleyerG Russell
Aug 19, 2007·Clinical Journal of the American Society of Nephrology : CJASN·Csaba P KovesdyKamyar Kalantar-Zadeh
Dec 11, 2007·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Antonio SantoroSilvio Cavalcanti
Aug 28, 2010·Clinical Journal of the American Society of Nephrology : CJASN·Maura WatsonChristina M Yuan
Sep 3, 2010·Kidney International·Patrick H PunJohn P Middleton
Oct 14, 2011·The New England Journal of Medicine·Robert N FoleyAllan J Collins
Mar 10, 2012·Clinical Journal of the American Society of Nephrology : CJASN·Michel JadoulBruce M Robinson
Jan 17, 2013·The American Journal of Medicine·Ziv HarelChaim M Bell
Feb 14, 2013·Renal Failure·Ahmed ChaabanMuhy Eddin Hassan
Jun 4, 2013·Lancet·Vivekanand JhaChih-Wei Yang
Nov 21, 2013·Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc·Chingping WanSteven J Szymkiewicz
Nov 22, 2014·The New England Journal of Medicine·David K PackhamBhupinder Singh
Dec 17, 2014·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Carlo BasileCarlo Lomonte
Apr 2, 2015·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Adriana M Hung, Raymond M Hakim
Jun 27, 2015·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Michael C G WongJoseph B Morton
Jul 15, 2015·JAMA : the Journal of the American Medical Association·George L BakrisUNKNOWN AMETHYST-DN Investigators
Sep 29, 2015·Clinical Kidney Journal·Francesco LocatelliSalvatore Di Filippo
May 6, 2016·Hemodialysis International·Jennifer Lee, David C Mendelssohn
Oct 27, 2016·American Journal of Nephrology·David A BushinskyRajiv Agarwal
Nov 22, 2016·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Angelo KaraboyasFrancesca Tentori
Jan 10, 2017·Seminars in Dialysis·Rita L McGill, Daniel E Weiner
Jan 24, 2017·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Steven M BrunelliDavid M Spiegel
Oct 11, 2017·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Steven M BrunelliCsaba P Kovesdy
Oct 11, 2017·Journal of the American Society of Nephrology : JASN·Patrick H Pun, John P Middleton

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Citations

Nov 6, 2018·Seminars in Dialysis·Keiichi Sumida, Csaba P Kovesdy

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