A recent social media (X) post by physician Dr. Priyam Bordoloi, MBBS, MD Internal Medicine final year resident described a case in which a patient with chronic kidney disease (CKD) developed severe hyperkalemia (High potassium) after consuming World Health Organization (WHO) oral rehydration solution (ORS) for mild diarrhea.
According to the post, the patient had a history of recurrent elevated potassium levels, with a previous serum potassium of 5.3 mEq/L. After being advised to consume WHO ORS for hydration by a quack, the patient presented to the emergency department with profound muscle weakness, palpitations and perioral numbness.
Laboratory results revealed a potassium level of 6.4 mEq/L, a value considered medically significant and potentially life-threatening.
Hyperkalemia refers to elevated potassium levels in the blood. Normal potassium levels typically range from 3.5 to 5.0 mEq/L.
In the post, Dr. Bordoloi reminds everyone why it is important to get medical advice only from qualified medical professionals, since even a simple ORS drink might put you in an emergency room.
According to the Centers for Disease Control and Prevention (CDC)1, chronic kidney disease is a condition in which the kidneys are damaged and cannot filter blood as effectively as they should.
Healthy kidneys perform several essential functions:
Remove waste and excess fluids
Maintain electrolyte balance (including potassium)
Regulate blood pressure
Support red blood cell production
CKD is typically defined by abnormalities in kidney structure or function lasting more than three months.
The CDC identifies the most common causes of CKD as:
Diabetes
High blood pressure (hypertension)
Heart disease
Family history of kidney disease
Other contributing factors may include autoimmune conditions, infections, and long-term use of certain medications.
In early stages, CKD may not cause noticeable symptoms. As the disease progresses, patients may experience:
Fatigue
Swelling in feet or ankles
Changes in urination patterns
Muscle cramps
Nausea
Shortness of breath
Electrolyte imbalances, particularly abnormal potassium levels, can also occur.
High Potassium levels result in muscle weakness, abnormal heart rhythms and even cardiac arrest.
WHO ORS is designed to treat dehydration caused by diarrhea. It contains a balanced mixture of:
Sodium
Glucose
Chloride
Potassium (approximately 20 mEq/L in standard formulation)
Citrate
In healthy individuals, ORS is widely regarded as safe and lifesaving, particularly in cases of infectious diarrhea.
However, in patients with advanced kidney disease, additional potassium intake may pose a risk if the kidneys cannot eliminate it effectively.
Reference
Centers for Disease Control and Prevention. “Preventing Chronic Kidney Disease” CDC. Accessed February 17th 2026. https://www.cdc.gov/kidney-disease/prevention/index.html
MSM