The following article features coverage from the American Society of Nephrology’s Kidney Week 2021. Click here to read more of Renal & Urology News’s conference coverage.

Hyperkalemia treated with medical management vs hemodialysis (HD) leads to comparable results, researchers reported at Kidney Week 2021, a virtual meeting of the American Society of Nephrology.

In a retrospective study of 569 patients presenting with serum potassium levels of 5.5 mmol/L or higher during 682 medical visits, patients were treated with HD (with or without medication) during 64 visits (9%)  and treated with medications exclusively during 618 visits (91%) within 3 hours. The medical management group received insulin, dextrose, sodium zirconium cyclosilicate, calcium gluconate, albuterol, or furosemide for treatment. The mean initial potassium levels were 6.45 and 6.21 mmol/L in the HD and medical management groups, respectively – a nonsignificant difference.

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Serum potassium declined similarly in both groups over time to 4.5-5.0 mmol/L in the HD group and 4.4-5.1 mmol/L in the medical management group, Joseph Aaron Gotesman, MD, and Maria V. DeVita, MD, of Lenox Hill Hospital in New York, New York, reported.

While these results need to be reproduced in larger studies and randomized trials, the potential clinical implications of this retrospective data are vast, Dr Gotesman told Renal & Urology News in an interview.

“Hyperkalemia affects nearly every field of medicine. Our ability as physicians to treat this disease with medical management [exclusively] would allow for expedient, consistent, and evidence-based care. Nationally standardized treatment algorithms ought to be developed.”


Gotesman JA, DeVita MV. Hyperkalemia: medical management vs. hemodialysis. Presented at: Kidney Week 2021; November 2-7, 2021. Poster: PO0892.