Question

A 72-year-old woman with chronic kidney disease stage 4 (eGFR 25 mL/min/1.73 m²) presents with serum potassium 6.4 mmol/L. ECG shows tall peaked T waves and widened QRS complexes. She is haemodynamically stable. What is the most appropriate immediate management step?

Accepted Answer

Intravenous calcium gluconate followed by insulin and glucose

Answer

Oral sodium polystyrene sulfonate only

Answer

Start haemodialysis only without temporising measures

Answer

Advise low-potassium diet and repeat level tomorrow

Answer

Intravenous frusemide alone

Practice question

A 72-year-old woman with chronic kidney disease stage 4 (eGFR 25 mL/min/1.73 m²) presents with serum potassium 6.4 mmol/L. ECG shows tall peaked T waves and widened QRS complexes. She is haemodynamically stable. What is the most appropriate immediate management step?