[Paradigm shift in the treatment of chronic hyperkalaemia to optimise cardiorenal patient prognosis].

Chronic hyperkalemia is an electrolyte imbalance that occurs mainly in patients with progressive kidney failure. It usually develops over a long period of time and symptoms are often mild. As chronic hyperkalemia is associated with increased morbidity and mortality, it should be treated. Treatment begins with a review of the medications that may be responsible for the hyperkalemia and careful therapy and correction of the metabolism. Dietary assessment now focuses on potassium intake from non-vegetable sources. Reducing the dose and/or discontinuing renin-angiotensin-aldosterone inhibitors should be discouraged, as these drugs improve the prognosis in patients with heart failure and proteinuric kidney disease. In addition to other conservative measures, specific potassium-binding substances should be used.