Severe Hypokalemia Induced by Hemodialysis

Clifford F. Wiegand, Thomas D. Davin, Leopoldo Raij, Carl M. Kjellstrand

Research output: Contribution to journalArticle

20 Scopus citations

Abstract

During dialysis, it is assumed that the serum electrolyte levels asymptotically approach the concentration in the dialysate. In five patients, we observed an average 20% fall in serum potassium level, although the dialysate contained 42% more potassium than the predialysis serum. One patient had quadriplegia and near respiratory arrest as a complication of hypokalemia. The cause of the hypokalemia was a rapid shift of potassium from the extracellular to the intracellular space secondary to correction of acidosis. All patients entered dialysis with a history suggesting prolonged potassium loss, marked acidosis, and moderate hypokalemia; thus, the dialysate potassium concentration should be higher than normal, and frequent determinations of the serum potassium level should be performed. Therapy resulting in rapid correction of acidosis in uremic patients undergoing hemodialysis may cause large transcompartmental shifts of potassium. Potassium transfer across the dialysis membrane may be inadequate to compensate for such shifts, and life-threatening hypokalemia may occur.

Original languageEnglish (US)
Pages (from-to)167-170
Number of pages4
JournalArchives of internal medicine
Volume141
Issue number2
DOIs
StatePublished - Feb 1981

ASJC Scopus subject areas

  • Internal Medicine

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    Wiegand, C. F., Davin, T. D., Raij, L., & Kjellstrand, C. M. (1981). Severe Hypokalemia Induced by Hemodialysis. Archives of internal medicine, 141(2), 167-170. https://doi.org/10.1001/archinte.1981.00340020029012