End-stage renal disease (ESRD) has emerged as an important public health issue worldwide due to the marked increase in its incidence and prevalence worldwide. Regardless of the fact that maintenance hemodialysis has been successful in prolonging survival of patients with ESRD, mortality rates still remain high. The annual mortality rates of hemodialysis patients in India have been estimated to be 9-13%. Moreover, the all-cause mortality rates in dialysis patients have been reported to be 6.3-8.2 times higher in patients undergoing dialysis as compared to the healthy population.1 One of the major causes of mortality in hemodialysis patients is sudden cardiac death which is attributed to hyperkalemia, thus signifying the importance of serum potassium evaluation in dialysis management. However, hypokalemia has emerged as another important cause which often remains underestimated and requires marked consideration and attention in terms of hemodialysis- associated mortality.