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Bradycardia, Renal Failure, Atrioventricular Nodal Blockade, Shock, and Hyperkalemia (BRASH) Syndrome Triggered by Missed Dialysis: A Case Report

Year: 2025

Type: article

Abstract: Bradycardia, renal failure, atrioventricular (AV) nodal blocker usage, shock, and hyperkalemia are the hallmarks of BRASH syndrome, a complex medical emergency. Despite having a high mortality rate, BRASH syndrome is underdiagnosed and frequently develops from the combined effects of renal failure and drug toxicity. Here, we present the case of an 86-year-old woman with end-stage renal disease (ESRD) who developed BRASH syndrome due to missed dialysis sessions, exacerbated by low-dose beta-blocker therapy. This case emphasizes how crucial it is to identify BRASH syndrome early, treat it quickly, and address its untoward events to avoid fatalities.

Source: Cureus

DOI: 10.7759/cureus.83713

Authors: Kesava Manikanta Achuta, Venkata Vedantam, Sai Karthik Kommineni, Neethu Vedantam, Kyasa S Venisha

Institutions: Michigan State University, East Tennessee State University

Language: English

Topic: Potassium and Related Disorders

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4410212655