Key result
Temporary pacing stabilizes hyperkalemia-induced junctional bradycardia to enable safe hemodialysis.
Why the study?
Hyperkalemia in chronic kidney disease can cause life-threatening rhythm disturbances and symptomatic bradycardia complicates hemodialysis initiation due to hemodynamic instability.
Case Report (n=1)
Temporary pacemaker placement can serve as a critical bridge to provide hemodynamic stability prior to and during urgent hemodialysis in patients with severe hyperkalemia-induced symptomatic bradycardia.
May support temporary pacing as bridge in select hyperkalemic bradycardia during dialysis; hypothesis-generating, requires prospective validation.
Background: Hyperkalemia in chronic kidney disease may cause life-threatening rhythm disturbances and often requires urgent hemodialysis. However, symptomatic bradycardia can complicate hemodialysis initiation due to the risk of hemodynamic instability. This case illustrates the role of temporary pacemaker placement as a bridge between metabolic correction and hemodialysis. Case Presentation: A 65-year-old woman with CKD presented with recurrent syncope (four episodes in 24 hours) and dyspnea. ECG showed junctional bradycardia (42 bpm), and laboratory findings included hemoglobin 7.3 g/dL, potassium 7.8 mmol/L, eGFR 8.17 mL/min/1.73m², and metabolic acidosis. The patient underwent temporary pacemaker implantation followed by correction of acidosis and hyperkalemia, and hemodialysis with blood transfusion. The pacemaker was removed on day 2 after the rhythm improved to sinus bradycardia (85 bpm). Renal ultrasonography revealed bilateral chronic parenchymal kidney disease and acute cystitis. Conclusion: Temporary pacemaker placement may provide essential hemodynamic support in patients with CKD.
No takes yet. Share an insight, caveat, or question.
Hamonangan et al. (2026) conducted a case report in Hyperkalemia and symptomatic bradycardia in chronic kidney disease (n=1). Temporary pacemaker placement was evaluated on Clinical stabilization and rhythm improvement. Temporary pacemaker placement provided essential hemodynamic support in a 65-year-old woman with chronic kidney disease and hyperkalemia-induced junctional bradycardia, enabling safe hemodialysis.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: