Abstract: TH-PO0079
Variability in Outpatient Hyperkalemia Management: A Cross-Sectional Survey
Session Information
- Fluid, Electrolyte, and Acid-Base Disorders: Clinical Research
October 22, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Fluid, Electrolytes, and Acid-Base Disorders
- 1102 Fluid, Electrolyte, and Acid-Base Disorders: Clinical
Authors
- Partida Garcia, Adriana Elizabeth, The University of British Columbia, Vancouver, British Columbia, Canada
- Picard, Kelly J., Vancouver Island Health Authority, Vancouver, British Columbia, Canada
- Renouf, Dani, Providence Health Care, Vancouver, British Columbia, Canada
- Ebel, Lauren Alana, Providence Health Care Research Institute, Vancouver, British Columbia, Canada
- Wong, Michelle M.Y., The University of British Columbia, Vancouver, British Columbia, Canada
Background
Hyperkalemia is a common electrolyte disturbance in ambulatory care for cardio-kidney-metabolic syndrome. However, its management remains inconsistent due to variability in laboratory practices, treatment thresholds and a lack of standardized approaches to care. Our objective was to describe real-world practice patterns regarding potassium (K+) monitoring and management.
Methods
A cross-sectional survey for healthcare professionals involved in cardio-kidney-metabolic syndrome management was distributed across Canada. The survey was open to physicians and allied health professionals, and was disseminated through professional societies in nephrology, cardiology, endocrinology, and primary care. It evaluated K+ management practices including laboratory monitoring , and dietary and medical management of K+.
Results
There were 226 respondents, with 189 (73%) working in the nephrology field. 73 respondents (31%) were unsure whether serum or plasma K+ was measured in their local laboratories. Median K+ thresholds for initiating any intervention were between 5.4-5.6 mEq/L, regardless of chronicity of hyperkalemia, magnitude of change from baseline, initiation of a medication that raised K+, or presence of acute health changes. The median K+ thresholds prompting various management strategies were: 5.3 (IQR 5.0-5.5) mEq/L for dietary counselling by non-dietitian, 5.5 (IQR 5.3-5.6) mEq/L for counselling by a dietitian, 5.8 (IQR 5.6-6.0) mEq/L for K+ binder, 6.2 (IQR 6.0-6.5) mEq/L for emergency department management, and 6.6 (6.5-7.0) mEq/L for urgent dialysis. The most commonly used initial strategy for K+ management was dietary counselling, and the most commonly advised foods to restrict were bananas, potatoes, and citrus fruits. Disagreements in management among colleagues were most often related to overtreatment of relatively mild hyperkalemia, inappropriate dietary restrictions and medication discontinuation.
Conclusion
Healthcare professionals managing potassium disorders showed relative consistency in intervention thresholds, however important variability persisted in laboratory interpretation, dietary potassium counselling, and treatment approaches. Improved interdisciplinary alignment is needed to optimize care. These findings will inform educational targets and the design of a future implementation study.
Funding
- Government Support – Non-U.S.