Criteria

European Resuscitation Council[3]

There is no universally accepted definition of hyperkalaemia. However, many guidelines, including the American College of Emergency Physicians hyperkalaemia management in the emergency department expert panel consensus and the UK Kidney Association (formerly the Renal Association) clinical practice guidelines on the treatment of acute hyperkalaemia in adults, use thresholds for serum potassium as defined by the European Resuscitation Council classification of severity of hyperkalaemia:[1]​[2]​[3]​

  • Mild hyperkalaemia: 5.5 to 5.9 mmol/L (5.5 to 5.9 mEq/L)

  • Moderate hyperkalaemia: 6.0 to 6.4 mmol/L (6.0 to 6.4 mEq/L)

  • Severe hyperkalaemia: ≥6.5 mmol/L (≥6.5 mEq/L).

Investigator Network Initiative Cardiovascular and Renal Clinical Trialists (INI-CRCT)[12]

INI-CRCT note that serum potassium levels of >6.0 mmol/L (>6.0 mEq/L) or >6.5 mmol/L (>6.5 mEq/L) or electrocardiogram (ECG) manifestations of hyperkalaemia (regardless of serum potassium level) have been recommended as thresholds for initiation of emergency therapy due to the risk of acute life-threatening cardiac rhythm disorders.

Kidney Disease: Improving Global Outcomes (KDIGO)[4]

KDIGO suggests classifying hyperkalaemia as mild, moderate, or severe based on the potassium concentration and the presence or absence of ECG changes.

[Figure caption and citation for the preceding image starts]: Severity of acute hyperkalaemia risk classification (KDIGO). *5.0 mmol/L (5.0 mEq/L) or upper limit of normal range. ECG, electrocardiogramClase et al. Kidney Int. 2020;97(1):42-61; used with permission [Citation ends].com.bmj.content.model.Caption@2b8f4e64

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