• Nephrology
• Clinical Procedures

Masilamani and van der Voort have written a useful treatise on acute hyperkalaemia.1 Could a retired nephrologist contribute a few comments? Elevated levels of potassium may well be serious, but hyperkalaemia remains an ill-defined entity. At times, the treatment strategies for raised potassium can be more harmful than the number itself. The current potassophobia is reminiscent of bilirubin vigintophobia (fear of 20 bilirubin >20 mg/dl or 340 mmol/l).

Where is the evidence that a potassium (K+) level in children >5.5 mol/l equals hyperkalaemia? No reference is given. The nephrology textbooks I consulted showed due discretion in defining hyperkalaemia in …