Toxicology Observation

Journal of Medical Toxicology

, Volume 7, Issue 1, pp 52-56

First online:

Acute Oral Potassium Overdose: The Role of Hemodialysis

  • George M. BosseAffiliated withDepartment of Emergency Medicine, University of Louisville Email author 
  • , Melissa A. PlattAffiliated withUniversity of Louisville
  • , Stephen D. AndersonAffiliated withBaptist Hospital
  • , Michael W. PresleyAffiliated withFrankfort Regional Medical Center

Abstract

Introduction

Hyperkalemia is a common condition, particularly in the setting of renal dysfunction. Hyperkalemia due to intentional oral potassium overdose is not commonly reported.

Case Report

We present a case of acute intentional potassium overdose in a patient with normal renal function resulting in significant hyperkalemia, with a maximum serum potassium concentration of 11 mEq/L. Despite an initial course complicated by various unstable cardiac rhythms, including ventricular tachycardia, ventricular fibrillation, and pulseless electrical activity, the patient was discharged from the hospital neurologically intact. Treatment for hyperkalemia included hemodialysis.

Discussion

The role of dialysis in potassium overdose is poorly defined.

Conclusion

Based on this case and a review of the medical literature, we recommend hemodialysis for cases of potassium overdose with hemodynamic instability and significantly elevated serum potassium concentrations that do not respond promptly to medical therapy. Hemodialysis should also be considered in cases with underlying renal dysfunction.

Keywords

Hyperkalemia Potassium Overdose Dialysis