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May 31, 2026Clinical Case Reports0 citationsOpen Access

BRASH Syndrome

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SISowdo Nur IyowAAAbdisamad Mohamed AdamHAHassan Adan Ali Adan

Key Result

Emergent hemodialysis significantly improved the condition of an 83-year-old female with BRASH syndrome refractory to standard bradycardia treatment.

Key Points

  • To describe the clinical characteristics and emergency management of BRASH syndrome in an elderly female patient.
  • Case report detailing the clinical condition of an 83-year-old female with chronic kidney disease and heart failure.
  • Intervention included emergent hemodialysis after standard treatment for bradycardia had failed.
  • Patient presented with severe bradycardia at 31 bpm, hyperkalemia at 6.9 mg/dL, and shock.
  • Condition improved significantly following hemodialysis, resolving the acute symptoms.

Study Design

Type

Case Report (n=1)

Structured PICO

P
Population
83-year-old female with a history of chronic kidney disease and heart failure, admitted with severe bradycardia, hyperkalemia, and shock (BRASH syndrome).
I
Intervention
Emergent hemodialysis
O
Outcome
Clinical improvement

Emergent hemodialysis can be an effective treatment for BRASH syndrome refractory to standard bradycardia therapies.

Abstract

ABSTRACT BRASH syndrome is a life‐threatening clinical entity characterized by Bradycardia, Renal failure, Atrioventricular (AV) blockade, Shock, and Hyperkalemia. This syndrome is often triggered in patients on AV nodal blocking agents who develop acute kidney injury, leading to a “vicious cycle” of worsening bradycardia and renal dysfunction. We present the case of an 83‐year‐old female with a history of chronic kidney disease and heart failure, who was admitted with severe bradycardia (31 bpm), hyperkalemia (6.9 mg/dL), and shock. Her condition was refractory to standard bradycardia treatment but improved significantly following emergent hemodialysis.

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Cite This Study

Iyow et al. (2026) conducted a case report in BRASH syndrome (n=1). Emergent hemodialysis vs. Standard bradycardia treatment was evaluated on Clinical improvement. Emergent hemodialysis significantly improved the condition of an 83-year-old female with BRASH syndrome refractory to standard bradycardia treatment.

synapsesocial.com/papers/6a1bd2ab5783ba022b6fe261https://doi.org/10.1002/ccr3.72833
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