RRT – Part 1

A 62-year-old male with septic shock and worsening acute kidney injury is admitted to the ICU. His urine output over the past 12 hours has been < 0.3 mL/kg/h despite adequate fluid resuscitation. He has developed refractory hyperkalemia (K⁺: 6.8 mEq/L) not responsive to insulin, bicarbonate, or beta-agonists. He is tachypneic (RR – 36/min), mildly confused (E3V4M6).  ECG shows junctional rhythm with a HR of 65/min with peaked T waves. The ICU team is considering starting RRT.