1352: Is Early Dialysis Indicated In Severe Hyperkalemia Associated With Diabetic Ketoacidosis?
1Wellstar Atlanta Medical Center, Atlanta, GA Learning Objectives: Hyperkalemia is a common lab abnormality in patients who present with diabetic ketoacidosis (DKA). It is mostly due to the underlying acidosis that causes intracellular potassium to shift into the extracellular space and usually corrects itself once acidosis improves. However, severe hyperkalemia which may be multi-factorial should be promptly identified and treated accordingly. Methods: A 44 years old African American male with history of type 1 diabetes mellitus and gastroparesis presented with nausea, vomiting and abdominal pain for two days. He was found on the ground by his mother, very weak and lethargic but arouse-able. Patients mother did not report any other symptoms. His only other history was hypertension and he was compliant with his home regimen of insulin and anti-hypertensives which included Lisinopril. On examination, patient was tachycardic, had dry mucus membranes, diffuse abdominal tenderness and had a port on his chest which was placed due to his recurrent episodes of DKA. He was anuric on admission and his lab values were significant for Na 126, K 9.0, Cl 87, CO2 7.4, BUN 87, creatinine 5.6 and Continue reading >>