Dialysate potassium concentration: Should mass balance trump electrophysiology?

Dialysate potassium concentration: Should mass balance trump electrophysiology?
Semin Dial. 2018 Jul 19;:
Authors: Pun PH
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.
PMID: 30027592 [PubMed - as supplied by publisher]

Source: Seminars in Dialysis - July 19, 2018 Category: Urology & Nephrology Authors: Pun PH Tags: Semin Dial Source Type: research