Criteria

European Resuscitation Council[3]

There is no universally accepted definition of hyperkalemia. However, many guidelines, including the American College of Emergency Physicians hyperkalemia 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 hyperkalemia in adults, use thresholds for serum potassium as defined by the European Resuscitation Council classification of severity of hyperkalemia:[1]​[2]​[3]​

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

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

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

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

INI-CRCT note that serum potassium levels of >6.0 mEq/L (>6.0 mmol/L) or >6.5 mEq/L (>6.5 mmol/L) or electrocardiogram (ECG) manifestations of hyperkalemia (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 hyperkalemia 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 hyperkalemia risk classification (KDIGO). *5.0 mEq/L (5.0 mmol/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@3dc1d40a

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