Successful Use of Renal Replacement Therapy for Refractory Hypokalemia in a Diabetic Ketoacidosis Patient
Joint Authors
Ismail, Mourad
Syed, Zainab
Kimball, Thomas
Source
Issue
Vol. 2019, Issue 2019 (31 Dec. 2019), pp.1-3, 3 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2019-08-14
Country of Publication
Egypt
No. of Pages
3
Main Subjects
Abstract EN
A 39-year-old African-American female presented to the emergency department with a seven-day history of right upper quadrant abdominal pain accompanied by nausea, vomiting, and diarrhea.
She was noted to be alert and following commands, but tachypneic with Kussmaul respirations; and initial laboratory testing supported a diagnosis of diabetic ketoacidosis (DKA) and hypokalemia.
To avoid hypokalemia-induced arrhythmias, insulin administration was withheld until a serum potassium (K) level of 3.3 mEq/L could be achieved.
Efforts to increase the patient’s potassium level via intravenous repletion were ineffectual; hence, an attempt was made at more aggressive potassium repletion via hemodialysis using a 4 mEq/L K dialysate bath.
The patient was started on Aldactone and continuous veno-venous hemodialysis (CVVH) with ongoing low-dose insulin infusion.
This regimen was continued over 24 h resulting in normalization of the patient’s potassium levels, resolution of acidosis, and improvement in mental status.
Upon resolution of her acidemia, the patient was transitioned from insulin infusion to treatment with a subcutaneous insulin aspart and insulin detemir, and did not experience further hypokalemia.
Considering our success, we propose CVVH as a tool for potassium repletion when aggressive intravenous (IV) repletion has failed.
American Psychological Association (APA)
Syed, Zainab& Kimball, Thomas& Ismail, Mourad. 2019. Successful Use of Renal Replacement Therapy for Refractory Hypokalemia in a Diabetic Ketoacidosis Patient. Case Reports in Critical Care،Vol. 2019, no. 2019, pp.1-3.
https://search.emarefa.net/detail/BIM-1134254
Modern Language Association (MLA)
Syed, Zainab…[et al.]. Successful Use of Renal Replacement Therapy for Refractory Hypokalemia in a Diabetic Ketoacidosis Patient. Case Reports in Critical Care No. 2019 (2019), pp.1-3.
https://search.emarefa.net/detail/BIM-1134254
American Medical Association (AMA)
Syed, Zainab& Kimball, Thomas& Ismail, Mourad. Successful Use of Renal Replacement Therapy for Refractory Hypokalemia in a Diabetic Ketoacidosis Patient. Case Reports in Critical Care. 2019. Vol. 2019, no. 2019, pp.1-3.
https://search.emarefa.net/detail/BIM-1134254
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1134254