Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
Indications for urgent referral to secondary care in patients presenting with hyperkalaemia include:
- Serum potassium concentration greater than 5.5 mmol/L, especially if associated with symptoms or ECG changes.
- Presence of cardiac arrhythmias or signs of cardiac instability, such as ventricular arrhythmia or new ECG abnormalities.
- Severe hyperkalaemia that poses an immediate risk of life-threatening complications.
- Patients with underlying conditions that increase the risk of adverse outcomes, such as chronic kidney disease, heart failure, or adrenal insufficiency.
- Hyperkalaemia occurring in the context of acute illness or medication changes that may worsen potassium balance.
- Inability to tolerate or safely manage hyperkalaemia in primary care, including failure of oral potassium-lowering treatments or need for intravenous therapy.
Urgent referral is necessary to enable continuous ECG monitoring, rapid potassium correction, and specialist management of underlying causes to prevent fatal complications NICE CKS,NICE NG136,NICE NG243.