Emergency treatment of excessive hyperkaliemia with ominous ECG-signs.

Potassium is mainly eliminated through the kidneys and accumulates when the renal function falls below 25 % of normal level. Medication and disease may trigger aggravation or the origin of renal failure. If renal failure progresses unnoticed, severe hyperkaliemia may be the result and lead to fatal arrhythmias. Two cases of excessive hyperkaliemia approximately 10 mmol/L are reported and etiologies, symptoms, ominous ECG-signs and treatments are reviewed. Among other things, these patients were being treated for systolic heart failure, hypertension and diabetes with ACE-I, ARB, MRA, BB, Digoxin and Metformin. In the first case, renal failure resulted from addition of NSAID and in the second case from dehydrating diarrhea. Both patients received emergency treatment with Calcium Chloride, Insulin-Glucose, Salbutamol and Hemodialysis and their lives were saved.