Myth💡: Lactated Ringer’s is Contraindicated in Hyperkalemia?!
Lactated Ringer’s (LR) solution, containing 4-5 mEq/L of potassium, is often avoided in patients with hyperkalemia due to concerns about increasing serum potassium levels. However, studies have shown that there is NO significant difference in serum potassium levels when comparing LR to normal saline (NS).
- LR may actually be preferable in certain cases because it has a lower risk of causing hyperchloremic metabolic acidosis compared to NS.
- The amount of potassium in LR is minimal and does not significantly impact serum potassium levels.
📌 Recommendation: LR is safe and appropriate for use in patients with hyperkalemia.
References
- Gupta AA, Self M, Mueller M, Wardi G, Tainter C. Dispelling myths and misconceptions about the treatment of acute hyperkalemia. Am J Emerg Med. 2022;52:85-91.
- Myth-busting: Lactated Ringers is safe in hyperkalemia, and is superior to NS. EMCrit Project. https://emcrit.org/pulmcrit/myth-busting-lactated-ringers-is-safe-in-hyperkalemia-and-is-superior-to-ns.
