Case history
Case history #1
A 65-year-old man who has end-stage kidney disease and is receiving hemodialysis presents to the emergency department with weakness and shortness of breath. He attends for dialysis three times a week but had to miss his last hemodialysis session due to a family emergency. He is anuric. On exam he has decreased strength in lower extremities, but strength in his upper extremities is intact. His vital signs are stable. Laboratory data is notable for a potassium of 7.2 mEq/L (7.2 mmol/L).
Case history #2
A 65-year-old woman with a medical history of diabetes, hypertension, and chronic kidney disease stage 4 attends for her yearly exam with her primary care physician. She says that over the past few weeks she has been finding it increasingly difficult to rise from her chair and has been having painful muscle cramps in her legs. Her potassium level is 6.6 mEq/L (6.6 mmol/L) and so she is sent to the emergency department for evaluation. Workup in the emergency department confirms her serum potassium is elevated.
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