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학습 자료 둘러보기 →In metabolic acidosis from CKD, hydrogen ions shift intracellularly, forcing potassium out of cells into the blood. This transcellular shift, combined with reduced renal excretion, rapidly elevates serum potassium to dangerous levels.
The primary life-threatening consequence is cardiac toxicity. As potassium rises above 5.0 mEq/L, cardiac cell resting potential becomes less negative, leading to slowed conduction and a high risk of lethal arrhythmias such as ventricular fibrillation or asystole.
Prioritize continuous cardiac monitoring and assessment for ECG changes (peaked T-waves, loss of P-waves) over chronic management tasks like dietary teaching or phosphate binder administration. Hyperkalemia is an immediate threat to circulation.
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