Are hemodialysis patients more tolerant of mild hyperkalemia as compared to the general population?
The lower susceptibility of ESKD patients to the cardiac toxicity of hyperkalemia may be attributable to its chronic nature. ESKD or advanced CKD patients may not demonstrate symptoms or EKG changes with serum potassium levels more than 6 mEq/L. In these patients, it is thought that membrane potentials of excitable cardiac tissues can adapt to the chronic elevation of potassium. In contrast, acute hyperkalemia can cause a rapid reduction in resting membrane potential, depolarization, muscle excitability, and EKG changes.
