Imran Saif, Abdul Halim, Ashfaq Altaf, Mohsin Saif, Umair Siddiqui, Muhammad Khalid Rahman, Nadeem Azam.
Severe post-dialysis hypokalemia leading to quadriparesis.
J Pak Med Assoc Jan ;58(1):41-3.

A 36-year-old male developed acute renal failure and severe metabolic acidosis following acute severe gastroenteritis. Two hours following haemodialysis he developed generalized muscle weakness, which progressed to quadriplegia over the next 4 hours. Electrocardiography (ECG) revealed classic signs of hypokalaemia. Serum potassium (K+) levels were 0.98 mmol/L. He was immediately started on intravenous (i/v) and oral potassium supplementation. He gradually improved and his ECG changes also reverted as potassium levels normalized. Postdialysis hypokalaemia can be a serious complication in patients who are already in total body potassium deficit. Dialysis fluid potassium levels should be kept higher in such patients.

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