Summary
Clinical management of patients with hyperkalemia in Emergency Departments in Spain
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Villarroel Vargas A, Sánchez Álvarez E, Álvarez-Rodríguez E, Alcázar R, Piñera Salmerón P, Fernández Rebollo N y el Comité Científico AKTUANDO*. Clinical management of patients with hyperkalemia in Emergency Departments in Spain. Rev Esp Urg Emerg. 2026;5:09–15
Summary
INTRODUCTION. Hyperkalemia is a common, recurrent, and potentially life-threatening electrolyte disorder that requires rapid intervention. To improve its management, the consensus document Recommendations for the Management of Hyperkalemia in Emergency Departments issued specific clinical practice guidelines.
OBJECTIVES. The primary endpoint of this study was to assess the adoption of these consensus recommendations by nephrologists and emergency physicians in Spain. Secondary endpoints were to describe the existence and degree of updating of hyperkalemia management protocols and to analyze the impact of greater knowledge of clinical practice guidelines and consensus documents on clinical practice.
MATERIALS AND METHODS. We conducted a descriptive, multicenter study based on responses to 8 questions exploring the knowledge and management of hyperkalemia among nephrologists and emergency physicians in Spain, collected across 40 meetings of the Medical Department of Diabetes & Renal Disease of AstraZeneca Spain (May 2022–June 2023).
RESULTS. Among the 451 participating clinicians, 77.5 % and 82.4 % demonstrated high knowledge of severity criteria and parameters for the rapid control of hyperkalemia. A total of 42.9 % showed high knowledge of recurrence risk, and 51.3 % reported modifying renin–angiotensin–aldosterone system inhibitor therapy in the context of hyperkalemia. Additionally, 42.1 % indicated that
they established a plan for reintroduction of these agents at discharge. Furthermore, 67.1 % reported considering treatment of patients at discharge with specific potassium-lowering agents, although half stated that these were not available at their centers.
Finally, greater knowledge levels were associated with improved management of hyperkalemia.
CONCLUSIONS. Adherence to consensus documents and clinical practice guidelines on hyperkalemia is heterogeneous. Knowledge
of these resources is associated with better management, which may translate into reduced morbidity and mortality and decreased
use of health care resources.