Hyperkalemia
Before treating the potassium, make sure it is real — then decide how dangerous it is.
Verify Plausibility
Hemolysis, difficult phlebotomy, marked thrombocytosis/leukocytosis and specimen handling can create pseudohyperkalemia.
Confirm the result before acting on it.
Risk Is More Than the Number
Interpret potassium with trajectory, kidney function, symptoms, ECG and acid-base/metabolic context.
A normal ECG does not guarantee safety in significant hyperkalemia.
Medication Stacks Matter
ACEi/ARB, MRAs, potassium supplements, trimethoprim, NSAIDs and other contributors can compound risk, especially during AKI or advanced CKD.
Review the full medication list before attributing the elevation to a single cause.
Shift vs Remove
Some acute therapies redistribute potassium intracellularly; they do not remove total-body potassium.
The cause and the patient's ability to excrete potassium still need attention.
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