Importance of History in the Management of New-Onset Hyperkalemia

Hyperkalemia is a life-threatening disorder with a multitude of causes. We present a case of a 64-year-old woman with new-onset hyperkalemia. A patient with a documented history of normokalemia developed consistent hyperkalemia on repeat blood testing. The patient was initially managed by her primary care physician, then referred to nephrology for persistent hyperkalemia, at which point sodium polystyrene sulfonate was initiated. The patient presented for a second opinion on the hyperkalemia, and after a thorough history and chart review, it was determined that the patient's dorzolamide-timolol eye drops were the cause of the hyperkalemia. Discontinuation of the eye drops resolved the hyperkalemia.