Which of the following is a non-drug treatment option in the management of hyperkalemia?

• A. Calcium gluconate
• B. Regular insulin with dextrose
• C. Furosemide
• D. Hemodialysis

Answer: (D)

Removing potassium directly from the body is the decisive approach when rapid correction is needed or kidney function is impaired. Hemodialysis uses a machine to filter the blood and exchange potassium with a dialysate, lowering serum potassium quickly regardless of renal function. This mechanical removal is what makes it a non-drug therapy.

Other options involve pharmacologic actions: calcium gluconate stabilizes cardiac membranes but doesn’t lower potassium itself; insulin with dextrose drives potassium into cells to reduce its blood level; and furosemide increases urinary potassium excretion but relies on functioning kidneys. In life-threatening or refractory hyperkalemia, dialysis provides the most direct, reliable means of removing excess potassium.