Management of hyperkalemia in children
- Michael J Somers, MD
Michael J Somers, MD
- Associate Professor of Pediatrics
- Harvard Medical School
Hyperkalemia is typically defined as a serum or plasma potassium greater than 5.5 mEq/L (mmol/L). Although children are less likely to develop hyperkalemia than adults, pediatric hyperkalemia is not an uncommon occurrence, and severe hyperkalemia (potassium level greater than 7 mEq/L [mmol/L]) is a serious medical problem that requires immediate attention.
The management of hyperkalemia in children is reviewed here. The etiology, clinical findings, diagnosis, and evaluation of pediatric hyperkalemia are presented separately. (See "Causes, diagnosis, and evaluation of hyperkalemia in children".)
Hyperkalemia in children is caused by derangements of the homeostatic mechanisms that normally regulate potassium balance, which are the same as those that occur in adults. However, the most common cause of an elevated potassium level is pseudohyperkalemia, which is typically caused by a hemolyzed blood sample.
Hyperkalemia is generally due to one or a combination of the following mechanisms (table 1):
●Excessive increase in potassium intake
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- RAPID THERAPY TO COUNTERACT CARDIAC EFFECTS
- Management approach
- - Cardiac membrane stabilization
- - Therapies shifting potassium into intracellular space
- TREATMENT OF REVERSIBLE CAUSES
- THERAPIES REMOVING POTASSIUM FROM THE BODY
- Enteral cation exchange resins
- CHRONIC HYPERKALEMIA
- SUMMARY AND RECOMMENDATIONS