Wednesday April 7, 2009

Scenario: 48 year old male, hemodialysis dependent, admitted with gastro-intestinal bleed. Last dialysis was 3 days ago. Patient received 4 units of pRBC and now hemodynamically stable. Nurse calls you as she felt that rhythm looks different on monitor. Patient is asymptomatic. Walking towards patient's bed what would be your top diagnosis ?


Answer: Hyperkalemia

Transfusion-associated hyperkalemia is a potential life threatening condition in patients with renal failure who have not been dialysed recently or with already elevated/borderline potassium level and should be followed closely.