Hyperkalemia is a common complication of maintenance hemodialysis (MHD) patients. When blood potassium concentration increases, it will not only change the gradient of potassium concentration inside and outside the cells and break the electrical stability of myocardial cells, but will also promote massive and rapid shift of potassium ions between serum and dialysate and inside and outside the cells during dialysis. These factors may increase the risk of arrhythmia in MHD patients. Therefore, it is very important to treat hyperkalemia in time and choose the best potassium prescription of dialysate. This review discusses the influence of hyperkalemia and dialysis treatment on electrocardiographic stability of hemodialysis patients and related treatment measures.