Dialysate potassium concentration: Should mass balance trump electrophysiology?


Journal Article (Review)

Nephrologists are faced with a difficult dilemma in choosing the ideal dialysis prescription to maintain neutral potassium mass balance. Should potassium mass balance goals prioritize the normalization of serum potassium levels using low potassium dialysate at the expense of provoking intradialytic arrhythmias, or should mass balance goals favor permissive hyperkalemia using higher dialysate potassium to avoid rapid intradialytic fluxes at the risk of more interdialytic arrhythmias? This review examines the factors that determine potassium mass balance among HD patients, the relationships between serum and dialysate potassium levels and outcomes, and concludes by examining currently available approaches to reducing risk of arrhythmias while managing potassium mass balance.

Full Text

Duke Authors

Cited Authors

  • Pun, PH

Published Date

  • November 2018

Published In

Volume / Issue

  • 31 / 6

Start / End Page

  • 569 - 575

PubMed ID

  • 30027592

Pubmed Central ID

  • 30027592

Electronic International Standard Serial Number (EISSN)

  • 1525-139X

Digital Object Identifier (DOI)

  • 10.1111/sdi.12738


  • eng

Conference Location

  • United States