Renal, Urology and Electrolytesmiddle twist
A 70-year-old man with diabetic kidney disease takes ramipril and spironolactone. Routine testing shows potassium 6.4 mmol/L, confirmed on a non-haemolysed sample; his ECG has no significant abnormalities and he is haemodynamically stable. He has no pulmonary oedema or other immediate indication for dialysis. Which treatment most rapidly lowers his serum potassium while definitive management is arranged?