Potassium levels requiring hospital admission

Dr Jürgen Floege is a professor of medicine and director of the Division of Nephrology and Clinical Immunology at the University Hospital RWTH Aachen (Germany), Distinguished Fellow of the European Renal Association (ERA-EDTA), and member of the International Society of Nephrology.

In an outpatient setting, until what value of potassium can we let an ambulatory patient go home with indications? When is hospitalization mandatory?

Jürgen Floege, MD, PhD: That is a difficult question because it fully depends on your patient. What I tell my students, and this is true for all electrolytes, is that what changes quickly is more dangerous, what changes slowly is less dangerous. I would certainly get nervous when my patient has a potassium level above 6.0 mEq/L.

The best way of judging whether hyperkalemia is dangerous or not is an electrocardiogram (ECG). If the T waves go up, your patient should be admitted to the hospital.