ABSTRACT
Hernodialysis(HD) patients are continuously exposed to hyperkalemia, the degree of which depends on the amount of dialysate potassium(K) removal and intra- compartmental K shifts besides poor dietary K compli- ance. Chronically hyperkalemic outpatients(n=20) on chronic hernodialysis by routine monthly serum potassium(SK) concentration measurements(SK> or =5.1mEq/L, more than 4 times in 6 months) was looked for the derangements of short-term interval K handling by observing the pattern of change in plasma K(PK) thru HD. In all 20 patients, as expected, the predialysis PK(PKo, 5.3 +/- 0.16mEq/L) were significantly correlated with the end-dialysis PK(PKe, 3.8+/-0.09mEq/l.)(r=0.65, p0.19 mEq/L). Between 2 groups, significant differences were found in plasma Na level(140 +/- 0.8 vs. 1360.7mEq/L, p<0.01) and the percentage of(PKr-PKe) divided by PKe(141.8 vs. 272.5Yo, p<0.01), but no difference in anion gap, pH, albumin, creatinine, and(PKo-PKe) divided by PKO, respectively. Based on this data, we conclude that hyperkalemic hemodialysis patients should be confirmed by plasma K determination to exclude factitious hyperkalemia, and they may have the derangements of internal K balance due to transcompartmental K shifts following HD, which would be partly related to that of Na balance.