Case description:

Patient admitted for anaemia and deterioration of renal function. Infiltrating rectal neoplasia was diagnosed after colonoscopy. Renal replacement therapy was started after placing a tunneled venous catheter. Prior to ileostomy, neoadjuvant radiotherapy was performed. Three months later, persistent severe hyperkalaemia appeared. Few cases have been described in the literature, but there seems to be a relationship with the interruption of intestinal transit.

Description/evaluation of the care plan:

Dietary reinforcement was performed, hemodialysis parameters were modified and treatment with resins was started, but potassium did not normalise until the ileostomy was closed. Resolving the hyperkalaemia was the main focus of the care plan, in addition to anxiety management and supporting the patient in stoma self-care. It was suggested that the alteration of homeostasis was due to a deficit of intestinal potassium secretion in the colon. The process of restoring intestinal continuity was accelerated with the closure of the ileostomy, confirming the suspicion.

Material and Method:

Hyperkalaemia in hemodialysis patients may be related to colon surgery. Our case demonstrates the importance of potassium secretion in the intestinal tract to maintain homeostasis in patients with end-stage renal failure.

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