Practices and Perceptions Regarding Hyperkalemia in Clinical Practice: A Survey Study in Central America and the Dominican Republic

A study examined physicians' attitudes and therapeutic approaches to hyperkalemia in Central America and the Dominican Republic through an online survey conducted between April and June 2025. A total of 362 physicians participated, primarily from Costa Rica (32.3%), Honduras (27.9%), and Guatemala (21.0%). Most respondents (37.8%) reported hyperkalemia in 10 to 30 percent of their patients, with the most common diagnostic threshold being serum potassium of 5.5 mEq/L. Outpatient intervention was most frequently initiated at 5.5 mEq/L (55.2%), while referral to the emergency department was reported at 6.0 mEq/L (35.6%). Regarding management, 67.0% of physicians preferred electrocardiogram before deciding on intervention, and 93.0% reported reduction or discontinuation of drugs causing hyperkalemia. Access to potassium monitoring differed significantly between the public sector (55.5%) and private sector (90.3%). The study revealed substantial heterogeneity in hyperkalemia definitions, intervention thresholds, and referral criteria.