Table 1:

Summary of suggested algorithms for managing dialysate potassium (dK) levels according to pre-dialysis serum potassium.

	Pre-Dialysis Serum Potassium (sK) Level (mEq/L)
	4	4.1–5.5	5.6–6.4	>6.5	Comments
“Rule of 7”	4 mEq/L	3 or 2 mEq/L	1 mEq/L	1 or 0 mEq/L	Potential for large serum-dialysate gradients; Potential for large mismatches without frequent follow-up of sK values.
Lee and Mendelsohn4	Increase current dK by 1 mEq/L to max of 4 mEq/L	Increase dK by 1 mEq/L to max of 3	2 mEq/L	2 mEq/L; Consider longer dialysis treatment time or frequent HD	Targets avoidance of low dK; found to result in only 4% of patients requiring dK changes after using algorithm for 5 months.
Abuelo51	Increase current dialysate by 1 mEq/L to max of 4 mEq/L	Maintain current dK level	Lower dK by 1 mEq to minimum of 0; consider other potassium lowering medications.	Targets avoidance of hyperkalemia
Pun and Middleton50	3 mEq/L; 4 mEq/L if persistent <sK<3.5; Avoid dialysate magnesium <1 mEq/L and bicarbonate >35 mEq/L	2 mEq/L	2 mEq/L + Add potassium binder. + Dietary counseling + Lengthen treatment time If above measures inadequate, lower to 1 mEq/L or consider dialysate profiling	Frequent potassium monitoring at least q week if utilizing dK>3 and <2 mEq/L and when sK <3.5 and >6.5.