Severe hyperkalaemia with prescription of potassium-retaining agents in an elderly patient.

Abstract

Jennifer Martin, Susannah Mourton and Gary NichollsPlasma levels of potassium are kept within the normal range through a complexinterplay of neurohormonal systems, acid-base balance, dietary electrolyte intake(both potassium and sodium), and renal function. Long-term maintenance of plasmapotassium within this normal range demands that elimination, dominated under mostcircumstances by urinary excretion, equates with dietary potassium intake. Whenmore than one renal excretory mechanism is impaired, hyperkalaemia may result.This case report describes a patient in whom hyperkalaemia developed, theconsequence of multiple factors acting to impair urinary potassium excretion.