| Patients with cardiovascular disease or chronic kidney disease should have their serum potassium level monitored routinely, especially if it is < 4 or > 5 mEq per L.5,9–11 |
B |
Large meta-analysis, large retrospective study, large propensity-matched study, and expert opinion |
| Most adults should consume 3,510 mg of potassium or more per day.12–14 |
B |
Two meta-analyses showing an association with fewer cardiovascular events |
| Patiromer (Veltassa) or sodium zirconium cyclosilicate (Lokelma) are preferred to sodium polystyrene sulfonate in patients with hyperkalemia due to higher efficacy and lower risk of serious adverse effects.52,66–68,70,71 |
B |
Two systematic reviews, a retrospective matched cohort study, and two consensus guidelines |
| The decision for urgent hyperkalemia treatment should not be based on electrocardiography results alone due to a lack of consistent threshold of electrocardiography changes.47,53–56 |
C |
Two small retrospective cohort studies, one small prospective cohort study, and expert consensus recommendations |
| Consider reinitiating renin-angiotensin-aldosterone system inhibitor therapy with potassium binders in patients who are hyperkalemic with chronic kidney disease, heart failure, or diabetic nephropathy.43,52 |
C |
Expert opinion |
| Intravenous potassium should be reserved for patients with severe hypokalemia, electrocardiography changes, physical signs or symptoms of hypokalemia, or for those unable to tolerate oral potassium supplementation.18,27,35 |
C |
Consensus guidelines |
