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

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.