More on Therapy for Hyperkalemia in Renal Insufficiency

To the Editor: Drs. Iqbal and Friedman (Jan. 5 issue)¹ commented on the results of a survey they conducted among directors of nephrology programs to determine what trainees are taught about treating potassium intoxication in patients with renal failure. Unlike Drs. Iqbal and Friedman, we concur with the respondents of the survey that neither nasogastric suction nor intravenous administration of loop diuretics should be used as part of first-choice therapy. Clearly, either maneuver exerts only a minimal effect, if any, on plasma potassium concentrations over a short period. What we wish to take issue with is the recommendation of intravenous.