Paradigmenwechsel in der Behandlung der chronischen Hyperkaliämie zur Optimierung der kardiorenalen Prognose

Chronic hyperkalemia is an electrolyte imbalance that occurs mainly in patients with progressive kidney failure. It usually develops over a long period of time and symptoms are often mild. As chronic hyperkalemia is associated with increased morbidity and mortality, it should be treated. Treatment begins with a review of the medications that may be responsible for the hyperkalemia and careful therapy and correction of the metabolism. Dietary assessment now focuses on potassium intake from non-vegetable sources. Reducing the dose and/or discontinuing renin-angiotensin-aldosterone inhibitors should be discouraged, as these drugs improve the prognosis in patients with heart failure and proteinuric kidney disease. In addition to other conservative measures, specific potassium-binding substances should be used.