The first symptom of hyperkalemia is death

Abstract

LetterSeptember 1, 2004The first symptom of hyperkalemia is deathCharles M. Grossman, MDCharles M. Grossman, MDPortland, Oregon, USA (C.M.G.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/ACPJC-2004-141-2-A14 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack Citations ShareFacebookTwitterLinkedInRedditEmail To the EditorThe editorial by Glasziou on hyperkalemia (1) brought to mind my old bias dating back more than 50 years. A serum potassium level of 7.3 mmol/L (7.3 mEq/L) in an otherwise-healthy individual does not fit the adage of a renal physician, “the first symptom of hyperkalemia is death.” I am convinced that any serious effect of hyperkalemia must result from the level of intracellular potassium, which we still are unable to measure clinically. One of the mechanisms of hyperkalemia is the release of potassium from cells, certainly not a dangerous situation. Might the 62% sensitivity reported for electrocardiographic ...Reference1 Glasziou P.Practice Corner: The first symptom of hyperkalemia is death [Editorial]. ACP J Club. 2004 Mar-Apr;104:A13-4. Google Scholar2 Cockcroft DW, Gault MH Prediction of creatinine clearance from serum creatinine. Nephron. 1976;16:31-41. [PMID: 1244564] Google Scholar3 Isaacs D, Fitzgerald D. Seven alternatives to evidence based medicine. BMJ. 1999;319:1618. [PMID: 10600968] Google Scholar4 Warrell DA, Cox TM, Firth JD, Benz EJ Jr., editors. Oxford Textbook of Medicine. 4th ed. Oxford: Oxford University Press; 2003. Google Scholar5 Martinez-Vea A, Bardaji A, Garcia C, Oliver JA. Severe hyperkalemia with minimal electrocardiographic manifestations: a report of seven cases. J Electrocardiol. 1999;32:45-9. [PMID: 10037088] Google Scholar Author, Article, and Disclosure InformationAffiliations: Portland, Oregon, USA (C.M.G.) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPractice Corner: The first symptom of hyperkalemia is death September 1, 2004Volume 141, Issue 2Page: A14KeywordsAnxietyBiochemistryCellsCreatinineDietElectrocardiographyGlomerular filtration rateHematologic testsHyperthermiaMusclesOverweightPotassiumProteinsReflexesRenal failureSpecificityTemperatureTendonsVital signs ePublished: 9 March 2020 Issue Published: September 1, 2004 Copyright & PermissionsCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...