AT PRESENT, almost one fourth of stage 5 CKD patients experience a life-threatening episode of hyperkalemia requiring emergency treatment, according to data cited in a recent article in Seminars in Dialysis (2007;20:431-439). The authors, Nirupama Putcha, MD, and Michael Allon, MD, note that although "many options have been proposed for the prevention of interdialytic hyperkalemia...prevention currently rests largely upon compliance with diet and a thoughtful use of medication regimens."