Cardiac excitability secondary to hyperkalemia with evidence of EKG
abnormalities should be treated with IV calcium gluconate at a dose of 0.5
ml/kg over 5–10 minutes. [34]
Renal replacement therapy (RRT)
Failure of improvement and/or progression of renal dysfunction despite
supportive therapy require more aggressive interventions such as renal
replacement therapy (RRT).
RRT refers to a form of therapy in which full support replaces most of the
kidney’s metabolic functions.
Classification of RRT
- Acute RRT
Include intermittent and acute hemodialysis. - Chronic RRT
Include intermittent hemodialysis, peritoneal dialysis and renal transplantation
(^) Indications for renal replacement therapy
The following are well recognized indications for RRT:
- Metabolic/electrolyte imbalance,
- Uremia with bleeding and/or encephalopathy,
- Hypervolemia with pulmonary edema/respiratory failure,
- Intoxications,
- Inborn errors of metabolism (IEM), and
- Nutritional support (removal of fluid to make space for nutrition)