A case of severe hyperkalaemia presenting with cardiac arrythmias: An uncommon initial manifestation of chronic kidney disease

Hyperkalaemia is a potentially fatal condition. The relationship between potassium (K⁺) level and symptoms may not be consistent, as patients with longstanding hyperkalaemia may be asymptomatic in spite of high K⁺ levels¹. The rapidity of change in K⁺ level influences the symptoms observed at any particular K⁺ concentration1. The most dangerous complication in patients with hyperkalaemia is cardiac arrhythmia. It is known that a K+ concentration greater than 10mmol/L is fatal, unless urgent treatment is instituted^2,3. This report describes a patient presenting with a cardiac arrythmia and extremely severe hyperkalaemia (9mmol/L) of uncertain duration, who subsequently recovered with medical management.