Which patient is at high risk for hyperkalemia?

The scenario of a patient at high risk for hyperkalemia is accurately represented by those with renal failure. In patients with renal failure, the kidneys are unable to effectively excrete potassium, leading to an accumulation of potassium in the bloodstream, which can result in hyperkalemia. The kidneys play a crucial role in maintaining potassium balance, and any impairment in their function significantly raises the risk of elevated serum potassium levels.

While the combination of NSAIDs and ACE inhibitors can indeed lead to elevated potassium levels due to the effects of both medications on renal function and the renin-angiotensin-aldosterone system, the profound and direct impact of renal failure on potassium excretion underscores why patients with this condition are particularly vulnerable to hyperkalemia.

Monitoring potassium levels is especially important in patients with renal issues, and proactive management of their condition can mitigate the risks associated with hyperkalemia.