BAGIAN ILMU PENYAKIT DALAM

RSUD ULIN, BANJARMASIN

KOREKSI HIPERKALEMIA

Julia Kasab

I4A012056

Pembimbing

Dr. Meldy Muzada Elfa, Sp.PD

 DETERMINING THE URGENCY OF THERAPY

Cause of

Mount DB. Treatment and prevention of hyperkalemia in adults. InUpToDate 2017. UpToDate,
Waltham (MA).
Mount DB. Treatment and prevention of hyperkalemia in adults. InUpToDate 2017. UpToDate,
Waltham (MA).
Mount DB. Treatment and prevention of hyperkalemia in adults. InUpToDate 2017. UpToDate,
Waltham (MA).
Mount DB. Treatment and prevention of hyperkalemia in adults. InUpToDate 2017. UpToDate,
Waltham (MA).
 Calcium

“Calcium directly antagonizes the membrane actions of

Fast effect,
1000
Calcium
mg (10 short lived hyperkalemia”

Mount DB. Treatment and prevention of hyperkalemia in adults. InUpToDate 2017. UpToDate,
Waltham (MA).
CALCIUM GLUCONATE
 Insulin with glucose
lowers the serum potassium concentration by driving
potassium into the cells, primarily by enhancing the
activity of the Na-K-ATPase pump in skeletal muscle.
10 to 20 units of short acting insulin in 500

Mount DB. Treatment and prevention of hyperkalemia in adults. InUpToDate 2017. UpToDate,
Waltham (MA).
The effect of insulin begins in 10 to
20 minutes, peaks at 30 to 60
minutes, and lasts for four to six
hours.
In almost all patients, the serum
potassium concentration drops by
0.5 to 1.2 mEq/L.
Insulin lowering potassium concentration

Mount DB. Treatment and prevention of hyperkalemia in adults. InUpToDate 2017.

UpToDate, Waltham (MA).
 Beta-2-adrenergic agonist – Albuterol
Like insulin, the beta-2-adrenergic agonists drive potassium into
the cells by increasing the activity of the Na-K-ATPase pump
in skeletal muscle. 

Lowering the serum potassium concentration by 0.5 to 1.5 

Mount DB. Treatment and prevention of hyperkalemia in adults. InUpToDate 2017. UpToDate,
Waltham (MA).
Albuterol 2.5 mg
 Sodium Bicarbonate-
NaHCO3
Raising the systemic pH with sodium bicarbonate results in hydrogen
ion release from the cells as part of the buffering reaction. This
change is accompanied by potassium movement into the cells
to maintain electroneutrality.
50
150

Mount DB. Treatment and prevention of hyperkalemia in adults. InUpToDate 2017. UpToDate,
Waltham (MA).
NaHCO3
REMOVAL POTASSIUM FROM THE
BODY
 LOOP DIURETICs
Increase potassium loss in the urine in patients with normal or mild to
moderately impaired renal function, particularly when combined
with saline hydration to maintain distal sodium delivery and flow. 

Mount DB. Treatment and prevention of hyperkalemia in adults. InUpToDate 2017. UpToDate,
Waltham (MA).
 Gastrointestinal cation exchangers
Patiromer or ZS-9, SPS-sodium polystyrene sulfonate 
Removes potassium by exchanging sodium ions for potassium
ions in the intestine (especially the large intestine) before the
resin is passed from the body;
Incication
 Potentially reduces potassium 0.93 mEq/L over 24 hours
Dialysis is not readily available
Other therapies to remove potassium have failed or are not possible
Newer
Patient has potentially life-threatening

Mount DB. Treatment and prevention of hyperkalemia in adults. InUpToDate 2017. UpToDate, Waltham (MA).
KALITAKE
 SPS-sodium polystyrene sulfonate 

Despite modest efficacy and the risk of catastrophic

consequences, SPS remains the most widely used treatment for
hyperkalemia.

Mount DB. Treatment and prevention of hyperkalemia in adults. InUpToDate 2017. UpToDate, Waltham (MA).
 DIALYSIS

Hemodyalisis
Indicated25
Remove
Rebound phenomenon
in to 50

Mount DB. Treatment and prevention of hyperkalemia in adults. InUpToDate 2017. UpToDate, Waltham (MA).
TERIMA KASIH.
Mount DB. Treatment and prevention of hyperkalemia in adults. InUpToDate 2017. UpToDate, Waltham (MA).
Mount DB. Treatment and prevention of hyperkalemia in adults. InUpToDate 2017. UpToDate, Waltham (MA).
Mount DB. Treatment and prevention of hyperkalemia in adults. InUpToDate 2017. UpToDate, Waltham (MA).
Mount DB. Treatment and prevention of hyperkalemia in adults. InUpToDate 2017. UpToDate, Waltham (MA).