Current Management of Hyperkalemia in Patients on Dialysis

Shweta Bansal, Pablo E. Pergola

Research output: Contribution to journalReview articlepeer-review

7 Scopus citations


Patients with end-stage renal disease (ESRD) on maintenance dialysis have a high risk of developing hyperkalemia, generally defined as serum potassium (K+) concentrations of >5.0 mmol/l, particularly those undergoing maintenance hemodialysis. Currently, the key approaches to the management of hyperkalemia in patients with ESRD are dialysis, dietary K+ restriction, and avoidance of medications that increase hyperkalemia risk. In this review, we highlight the issues and challenges associated with effective management of hyperkalemia in patients undergoing maintenance dialysis using an illustrative case presentation. In addition, we examine the potential nondialysis options for the management of these patients, including use of the newer K+ binder agents patiromer and sodium zirconium cyclosilicate, which may reduce the need for the highly restrictive dialysis diet, with its own implication on nutritional status in patients with ESRD, as well as reducing the risk of potentially life-threatening hyperkalemia.

Original languageEnglish (US)
Pages (from-to)779-789
Number of pages11
JournalKidney International Reports
Issue number6
StatePublished - Jun 2020
Externally publishedYes


  • dialysis
  • end-stage renal disease
  • hyperkalemia
  • patiromer
  • serum potassium
  • sodium zirconium cyclosilicate

ASJC Scopus subject areas

  • Nephrology


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