2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T585,In patients with incident end-stage kidney disease (ESKD), hyperkalemia (HyperK) is a common indication for initiating kidney replacement therapy (KRT). Hemodialysis (HD) and peritoneal dialysis (PD) both effectively reduce serum potassium, but HD is often considered superior due to its perceived faster efficiency. However, evidence supporting this perception remains limited. We hypothesized that HD and PD would be equally effective for the management of severe HyperK during hospitalization. We conducted a prospective cohort study at the Nephrology Department of Hospital Civil de Guadalajara. Consecutive, dialysis-naïve patients hospitalized with ESKD and severe HyperK (serum potassium >6.5 mEq/L at admission) between 2022 and 2024 were included. The modality of KRT (HD vs PD) was determined by the treating nephrology team. The primary outcome was the trajectory of serum potassium reduction between groups. Secondary outcomes included daily potassium trajectory, catheter dysfunction, length of stay and mortality. Eighty-two patients were included: 34 initiated PD, 37 HD and 11 received conservative management. Baseline demographic and clinical characteristics were similar across groups ( In this prospective cohort of ESKD patients with severe HyperK, both PD and HD achieved comparable potassium reduction and clinical outcomes, supporting PD as an effective alternative for urgent-start KRT.31:Tb3b,ABSTRACT Introduction In patients with incident end-stage kidney disease (ESKD), hyperkalemia (HyperK) is a common indication for initiating kidney replacement therapy (KRT). Hemodialysis (HD) and peritoneal dialysis (PD) both effectively reduce serum potassium, but HD is often considered superior due to its perceived faster efficiency. However, evidence supporting this perception remains limited. We hypothesized that HD and PD would be equally effective for the management of severe HyperK during hospitalization. Methods We conducted a prospective cohort study at the Nephrology Department of Hospital Civil de Guadalajara. Consecutive, dialysis-naïve patients hospitalized with ESKD and severe HyperK (serum potassium >6.5 mEq/L at admission) between 2022 and 2024 were included. The modality of KRT (HD vs PD) was determined by the treating nephrology team. The primary outcome was the trajectory of serum potassium reduction between groups. Secondary outcomes included daily potassium trajectory, catheter dysfunction, length of stay and mortality. Results Eighty-two patients were included: 34 initiated PD, 37 HD and 11 received conservative management. Baseline demographic and clinical characteristics were similar across groups (P > .05). Median age was 65 years [interquartile range (IQR) 53–74], with diabetes in 33% and hypertension in 53%. Median admission potassium was 6.99 mEq/L (6.7–7.6), serum creatinine 15.9 mg/dL (11.5–23.1) and estimated glomerular filtration rate 2.91 mL/min/1.73 m² (1.80–4.09). The PD group underwent a mean of 45 (±15) exchanges during hospitalization, and the HD group received 4.6 (±1) sessions. Serum potassium decreased similarly in both groups (P > .05), with substantial reductions on Day 1 (PD 6.03 mEq/L; HD 5.90 mEq/L) and stabilization by Day 5 through Day 15. Catheter dysfunction occurred in 11% of patients, with similar rates between groups, hospitalization median was 5 days (IQR 3–8) and 12-month mortality was 26.8%, without differences between modalities. Conclusions In this prospective cohort of ESKD patients with severe HyperK, both PD and HD achieved comparable potassium reduction and clinical outcomes, supporting PD as an effective alternative for urgent-start KRT. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Hyperkalemia: condition Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Hyperkalemia (condition). Clinician-written summaries and actionable practice insights. 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ECG-to-intervention delays were notable for hyperkalemia (111 min to calcium) and MI (76 min to aspirin) despite ECG changes, while opioid overdose had near-immediate response (1 min to naloxone).","limitations":"Single-centre quality improvement design at two affiliated academic EDs limits generalizability. Retrospective chart review is subject to documentation bias. No control group or pre/post intervention comparison was performed.","practice_takeaway":"Treat secondary bradycardia as a high-acuity emergency — it carries ~5× the mortality of primary bradycardia. Prioritize rapid calcium administration in hyperkalemia and early warming in sepsis-related hypothermia, as ECG-to-intervention times for these conditions lagged well behind opioid overdose and intracranial emergencies."}},{"doi":"10.1080/0886022x.2026.2709935","pmid":"42549818","title":"Development of a nomogram for predicting hyperkalemia in advanced chronic kidney disease","journal_title":"Renal Failure","journal_issn":"0886-022X","published_at":"2026-08-04T00:00:00.000Z","url":"https://doi.org/10.1080/0886022x.2026.2709935","source_score":28,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-07T13:23:04.684Z","updated_at":"2026-08-07T13:23:04.684Z","tags":[{"paper_doi":"10.1080/0886022x.2026.2709935","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1080/0886022x.2026.2709935","tag_type":"category","value":"Urology & Nephrology","value_numeric":null},{"paper_doi":"10.1080/0886022x.2026.2709935","tag_type":"condition","value":"Chronic Kidney Disease","value_numeric":null},{"paper_doi":"10.1080/0886022x.2026.2709935","tag_type":"condition","value":"Hyperkalemia","value_numeric":null},{"paper_doi":"10.1080/0886022x.2026.2709935","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1080/0886022x.2026.2709935","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1080/0886022x.2026.2709935","tag_type":"modality","value":"Prediction Model / Nomogram","value_numeric":null},{"paper_doi":"10.1080/0886022x.2026.2709935","tag_type":"modality","value":"Thiazide Diuretic","value_numeric":null},{"paper_doi":"10.1080/0886022x.2026.2709935","tag_type":"sample_size","value":"n=395","value_numeric":395},{"paper_doi":"10.1080/0886022x.2026.2709935","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1080/0886022x.2026.2709935","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1080/0886022x.2026.2709935","tag_type":"warning","value":"Follow-up duration was up to 2.2 years but the median or mean follow-up was not reported in the abstract, limiting interpretation of event rates over time.","value_numeric":null},{"paper_doi":"10.1080/0886022x.2026.2709935","tag_type":"warning","value":"Obesity was listed as protective against hyperkalemia risk, which is counterintuitive; clinicians should note this may reflect residual confounding or a specific characteristic of the study population.","value_numeric":null},{"paper_doi":"10.1080/0886022x.2026.2709935","tag_type":"warning","value":"The impact_flag 'practice_changing' reflects the novelty of sex-specific validated nomograms for this population, but should be interpreted cautiously given the single-center, retrospective design and lack of external validation.","value_numeric":null}],"summaries":{"what_studied":"Retrospective cohort study of 395 outpatients with CKD stages 4–5 (baseline serum potassium within normal range) followed up to 2.2 years, evaluating predictors of hyperkalemia and developing sex-stratified nomograms using LASSO-selected logistic regression.","key_result":"76% of patients (303/395) developed hyperkalemia. Higher creatinine, calcium, and age increased risk; higher sodium, hemoglobin, obesity, and thiazide use were protective. Men had 49% lower odds than women (OR 0.51, 95% CI 0.28–0.92). Sex-specific nomograms achieved AUROCs of 0.78 (men) and 0.81 (women), with negative predictive values >95%.","limitations":"Single-center retrospective design limits generalizability; internal validation only (no external validation cohort); relatively small sample size (n=395) may affect model stability.","practice_takeaway":"Use the sex-specific nomogram to identify low-risk advanced CKD patients who may safely need less intensive potassium monitoring. Thiazide use and higher hemoglobin/sodium levels were associated with lower hyperkalemia risk and may inform medication and monitoring decisions."}},{"doi":"10.1093/ckj/sfaf343","pmid":"41333670","title":"Urgent initiation of hemodialysis versus peritoneal dialysis in severe hyperkalemia: a prospective study","journal_title":"Clinical Kidney Journal","journal_issn":"2048-8505","published_at":"2025-12-03T00:00:00.000Z","url":"https://doi.org/10.1093/ckj/sfaf343","source_score":38,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2025-11-10","doi":"10.1093/ckj/sfaf343","days":"30","issn":"2048-8505","rank":"5","field":"Clinical Medicine","score":"38","category":"Urology & Nephrology","categories":["Urology & Nephrology"],"_categories":["Urology & Nephrology"]},"pubmed":{"doi":"10.1093/ckj/sfaf343","title":"Urgent initiation of hemodialysis versus peritoneal dialysis in severe hyperkalemia: a prospective study.","journal":"Clinical kidney journal","methods":"","results":"Eighty-two patients were included: 34 initiated PD, 37 HD and 11 received conservative management. 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