Q: 57 year old male with ESRD is admitted to ICU with hyperkalemia in "7.5 range" causing EKG changes and arrhythmias. Emergent dialysis(HD) is called. Patient tolerated dialysis very well and now has stable hemodynamics. When should potassium level should be checked again?

A) Continuously during HD

B) Immediately after HD

C) 30 minutes after HD

D) After few hours of HD 

Answer: D

Hemodialysis (HD)  is the most effective treatment of hyperkalemia and will cause a fall in both intracellular and extracellular levels. Extreme caution should be exercise while following potassium level as the potassium levels tend to rebound after dialysis. Potassium level should never be checked immediately after dialysis. A potassium level drawn several hours after hemodialysis is reliable.