Hyperkalaemia Management Algorithm
Grades hyperkalaemia severity and guides sequential management from ECG stabilisation to potassium excretion per Renal Association/NICE guidelines.
Score interpretation
→ Review and stop exacerbating drugs (ACEi, ARB, NSAID, K-sparing diuretics, trimethoprim); dietary K restriction; reassay in 24-48h; treat underlying cause (AKI, Addison); Patiromer or sodium zirconium cyclosilicate if chronic CKD
→ Continuous cardiac monitoring; IV salbutamol 10-20mg nebulised; IV insulin-dextrose (10 units actrapid in 50ml 50% dextrose over 15 min + 100ml 20% dextrose); 1h recheck K; calcium resonium 15g TDS or SZC 10g TDS for excretion
→ IV calcium gluconate 10ml 10% over 2-3 min immediately (ECG stabilisation); repeat if no ECG response; insulin-dextrose and salbutamol as above; consider sodium bicarbonate if acidotic; renal team — haemodialysis if refractory; ICU monitoring
Interpretation bands for the Hyperkalaemia Management. Apply clinical judgement and local guidance.
References
Related
Curated clinical cross-links plus same-class fallbacks.
- Calcium Gluconate · Electrolyte — Calcium Supplement
- Calcium Gluconate 10% · Electrolyte
- Potassium Chloride (IV) · Electrolyte — Potassium Supplement
- Insulin (IV Infusion — ICU Glucose Control) · Insulin — ICU Glucose Management
- Sodium Chloride 3% (Hypertonic Saline) · Hypertonic Electrolyte Solution — ICP/Hyponatraemia Management
- Potassium chloride with calcium chloride and sodium chloride · Crystalloid IV fluid
- Falls Assessment in Older Adults · NICE CG161 2013
- Anaemia Investigation · BSH / NICE
- Lower Respiratory Tract Infection (Primary Care) · NICE NG138 / NICE antimicrobial guidance
- Hypertension Management · NICE NG136 2019
- Hyperkalaemia Management · UK Kidney Association Guidelines 2020; NICE CKD Guidelines
- Rhabdomyolysis · Renal Association 2018; UpToDate 2024
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.