[elmatador_68]

pardon me if this is a silly question, but the argument was, since the blood becomes concentrated when removing fluids, there is a tendency
that the potassium will increase. I disagree with this one. any comment please.
thank you very much

elma

[WINDYCITYRN]

I would agree with you, from my experience the issue of potassium going up because of fluid removal has never come up. I have never seen an overloaded pt with a normal K end up with an elevated K after dialysis using standard 2 K bath. And in almost every case, a person with fluid overload with elevated K (6-7 for example) will come down to normal K with 3,4 or 5 liters fluid taken off, thats from my experience, hope its helpful.

[DeLana_RN]

If you are just ultrafiltrating the pt (i.e., running him/her in bypass), you would not remove any K+ (or other substances), just fluid. Of course, the total body K+ would not change, but due to hemoconcentration, the same amount of blood would now yield a higher K+ level. However...

... this would not matter in practice, because labs should be done before tx is even prescribed; otherwise, the nephrologist would probably not order UF only/bypass. With a normal dialysis tx, the K+ level would of course decrease.

With hemodilution caused by severe fluid overload, it can probably be safely assumed that the true K+ level would be even higher than the lab result suggests.

DeLana

[elmatador_68]

Thank you very much for the answers.

elma

[Sarah Kay]

I agree that the hemoconcentration could increase the serum potassium level but....wouldn't the pt be getting a UF run for fluid overload in addition to their 3x/week treatment schedule? Therefore, the K+ level wouldn't really be a concern unless its a chronic problem, which would likely be monitored by weekly K+ labs (at least) and possibly kayexalate.