Today, I review, link to, and excerpt from The Curbsiders‘ “#537 Hyperkalemia and Hypokalemia”.*
*Achi SS, Topf J, Williams PN, Watto MF. “#537 Hyperkalemia and Hypokalemia”. The Curbsiders Internal Medicine Podcast. thecurbsiders.com/category/curbsiders-podcast August 24, 2026.
Transcript available via YouTube
I’m Going Bananas for This One!
Learn how to formulate a framework while dealing with potassium disorders in patients with varying levels of kidney disease.We’re joined by Dr Joel Topf, (@kidney_boy) to explore how to navigate potassium disorders, develop etiology frameworks, and treat these patients.
Claim CME for this episode at curbsiders.vcuhealth.org!
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Show Segments
- Intro
- Rapid fire questions/Picks of the Week
- Case 1: Hyperkalemia
- How to Approach Patients with Hyperkalemia
- Treatment Options for Hyperkalemia
- Case 2: Hypokalemia
- How to Approach Patients With Hypokalemia
- Treatment Options for Hypokalemia
- Case 3: Hyperkalemia in ESKD patients
- How To Approach the Management in ESKD patients
- Take Home Points
- Outro
Disclosures
Dr. Topf reports the following conflicts of interests: Advisor-Travere Therapeutics, Advisor-Otsuka, Advisor-Vera Therapeutics, Advisor-Novartis, Advisor-Vertex Therapeutics
The Curbsiders report no relevant financial disclosures.
Hyperkalemia and Hypokalemia Pearls
- In a case of hyperkalemia, the first step is to rule out any cause of pseudohyperkalemia: such as hemolyzed samples
- Hyperglycemia can cause hyperkalemia due to solute drag; if the sugars can be controlled, then that will aid in the control of hyperkalemia.
- Medications can also lead to hyperkalemia so it’s important to do a thorough medication check.
- The potassium switch manages high potassium through inactivation of a sodium-chloride transporter, causing a thiazide-like effect of distal sodium delivery and increased excretion of sodium and potassium
- Even in dialysis patients who have hyperkalemia, there are roles for potassium binders
- Proton pump inhibitors often cause hypomagnesemia and related hypokalemia; with repletion of magnesium, the potassium should improve.
