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Hyperkalaemia in an elderly diabetic patient

Department of Geriatric Medicine, Caerphilly District Miners Hospital, Gwent Healthcare NHS Trust and University College of Medicine, Cardiff, Wales

Correspondence to:
Correspondence to:
Dr M Hasan, Caerphilly District Miners' Hospital, St Martin's Road, Caerphilly CF83 2WW, UK;
hasanm@cf.ac.uk

Submitted 18 December 2000
Accepted 23 January 2001

Keywords: hyperkalaemia; diabetes

A 76 year old man was referred to casualty with a non-haemolysed serum potassium of 6.6 mmol/l. He was entirely asymptomatic. He had a past medical history of type II diabetes mellitus with diabetic nephropathy, hypercholesterolaemia, and cerebrovascular disease with a residual left hemiparesis from a previous stroke. He had recently increased his coffee intake and had started drinking four glasses of orange juice daily. His medications were aspirin 75 mg daily, cerivastatin 100 µg daily, gliclazide 160 mg twice a day, and nebivolol 5 mg daily (recently started for newly diagnosed hypertension)

On examination his blood pressure was 172/88 mm Hg and he had both left upper and lower limb weakness consistent with a previous stroke. He had some evidence of peripheral neuropathy but nothing to suggest a proximal myopathy. Examination was otherwise unremarkable. His electrocardiograph showed peaked T waves in most leads.

Initial investigations showed: serum sodium . . . [Full text of this article]

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