BRASH Syndrome.

BRASH syndrome is a life-threatening clinical entity characterized by Bradycardia, Renal failure, Atrioventricular (AV) blockade, Shock, and Hyperkalemia. This syndrome is often triggered in patients on AV nodal blocking agents who develop acute kidney injury, leading to a "vicious cycle" of worsening bradycardia and renal dysfunction. We present the case of an 83-year-old female with a history of chronic kidney disease and heart failure, who was admitted with severe bradycardia (31 bpm), hyperkalemia (6.9 mg/dL), and shock. Her condition was refractory to standard bradycardia treatment but improved significantly following emergent hemodialysis.