Clinical recommendationEvidence ratingReferences
Patients with hyperkalemia who have electrocardiographic (ECG) changes, a rapid rate of rise of serum potassium, decreased renal function, or significant acidosis should be urgently treated.C23
Patients with hyperkalemia and characteristic ECG changes should be given intravenous calcium gluconate.C13,27
Acutely lower potassium by giving intravenous insulin with glucose, a beta2 agonist by nebulizer, or both.C2,3,30
Total body potassium should usually be lowered with sodium polystyrene sulfonate (Kayexalate).C2,3,23