Hyperkalemia: Difference between revisions
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{{Infobox medical condition | |||
| name = Hyperkalemia | |||
| image = [[File:ECG_in_hyperkalemia.svg|left|thumb|ECG changes in hyperkalemia]] | |||
| caption = ECG changes in hyperkalemia | |||
| field = [[Nephrology]], [[Cardiology]] | |||
| symptoms = [[Muscle weakness]], [[fatigue]], [[palpitations]], [[paresthesia]] | |||
| complications = [[Cardiac arrest]], [[arrhythmia]] | |||
| onset = Sudden or gradual | |||
| duration = Variable | |||
| causes = [[Kidney failure]], [[medications]], [[acidosis]], [[cellular breakdown]] | |||
| risks = [[Diabetes]], [[heart failure]], [[chronic kidney disease]] | |||
| diagnosis = [[Blood test]] for [[serum potassium]] | |||
| differential = [[Hypokalemia]], [[pseudohyperkalemia]] | |||
| prevention = [[Dietary management]], [[medication review]] | |||
| treatment = [[Calcium gluconate]], [[insulin]], [[beta-2 agonists]], [[dialysis]] | |||
| prognosis = Depends on underlying cause and treatment | |||
| frequency = Common | |||
}} | |||
Higher than normal levels of [[potassium]] in the circulating [[blood]] is called hyperkalemia and is associated with [[kidney failure]] or sometimes with the use of [[diuretic drugs]]. | Higher than normal levels of [[potassium]] in the circulating [[blood]] is called hyperkalemia and is associated with [[kidney failure]] or sometimes with the use of [[diuretic drugs]]. | ||
[[File:Hyperkalemia.pdf|alt=Cause of hyperkalemia|thumb|Cause of hyperkalemia]] | [[File:Hyperkalemia.pdf|alt=Cause of hyperkalemia|left|thumb|Cause of hyperkalemia]] | ||
==Causes== | ==Causes== | ||
Potassium is a mineral that is needed for our cells to function properly which is normally obtained via [[food]]. | Potassium is a mineral that is needed for our cells to function properly which is normally obtained via [[food]]. | ||
===Role of kidneys=== | ===Role of kidneys=== | ||
The kidneys remove excess potassium through the urine to keep a proper balance of this mineral in the body. When the kidneys are not working well, they may not be able to remove the proper amount of potassium leading to hyperkalemia. | The kidneys remove excess potassium through the urine to keep a proper balance of this mineral in the body. When the kidneys are not working well, they may not be able to remove the proper amount of potassium leading to hyperkalemia. | ||
'''Some of the causes include:''' | '''Some of the causes include:''' | ||
* [[Addison disease]] -- Disease in which the adrenal glands do not make enough hormones, reducing the kidneys' ability to remove potassium from the body | * [[Addison disease]] -- Disease in which the adrenal glands do not make enough hormones, reducing the kidneys' ability to remove potassium from the body | ||
| Line 16: | Line 33: | ||
* Taking extra potassium, such as salt substitutes or supplements | * Taking extra potassium, such as salt substitutes or supplements | ||
* [[Tumors]] | * [[Tumors]] | ||
[[File:Hyperkalemia ECG.jpg|alt=Hyperkalemia ECG|thumb|'''Hyperkalemia ECG''']] | [[File:Hyperkalemia ECG.jpg|alt=Hyperkalemia ECG|left|thumb|'''Hyperkalemia ECG''']] | ||
==Symptoms== | ==Symptoms== | ||
While it can be asymptomatic, some may experience the following symptoms: | While it can be asymptomatic, some may experience the following symptoms: | ||
| Line 25: | Line 42: | ||
* Palpitations | * Palpitations | ||
* Sudden collapse, when the heartbeat gets too slow or even stops | * Sudden collapse, when the heartbeat gets too slow or even stops | ||
[[File:ECG in hyperkalemia.png|alt=ECG in hyperkalemia|thumb|ECG in hyperkalemia]] | [[File:ECG in hyperkalemia.png|alt=ECG in hyperkalemia|left|thumb|ECG in hyperkalemia]] | ||
==Tests== | ==Tests== | ||
* Electrocardiogram (ECG) | * Electrocardiogram (ECG) | ||
* Blood potassium level | * Blood potassium level | ||
[[File:ECG demonstrating hyperkalemia with absent P waves.png|alt=ECG demonstrating hyperkalemia with absent P waves|thumb|ECG demonstrating hyperkalemia with absent P waves]] | [[File:ECG demonstrating hyperkalemia with absent P waves.png|alt=ECG demonstrating hyperkalemia with absent P waves|left|thumb|ECG demonstrating hyperkalemia with absent P waves]] | ||
==Treatment== | ==Treatment== | ||
* You will need emergency treatment if your potassium level is very high, or if you have danger signs, such as changes in your ECG. | * You will need emergency treatment if your potassium level is very high, or if you have danger signs, such as changes in your ECG. | ||
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* [[Glucose]] and [[insulin]] given into your veins (IV) to help lower potassium levels long enough to correct the cause | * [[Glucose]] and [[insulin]] given into your veins (IV) to help lower potassium levels long enough to correct the cause | ||
* [[Dialysis]] if your kidney function is poor | * [[Dialysis]] if your kidney function is poor | ||
'''Other medicines''' | '''Other medicines''' | ||
* [[Sodium bicarbonate]] if the problem is caused by acidosis | * [[Sodium bicarbonate]] if the problem is caused by acidosis | ||
* Some [[diuretics]] that increase the excretion of potassium by your kidney | * Some [[diuretics]] that increase the excretion of potassium by your kidney | ||
* Changes in your diet can help both prevent and treat high potassium levels. | * Changes in your diet can help both prevent and treat high potassium levels. | ||
===Dietary changes=== | ===Dietary changes=== | ||
* Limit or avoid [[asparagus]], [[avocados]], [[potatoes]], [[tomatoes]] or [[tomato sauce]], [[winter squash]], [[pumpkin]], and [[cooked spinach]] | * Limit or avoid [[asparagus]], [[avocados]], [[potatoes]], [[tomatoes]] or [[tomato sauce]], [[winter squash]], [[pumpkin]], and [[cooked spinach]] | ||
Latest revision as of 01:08, 8 April 2025
Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC
| Hyperkalemia | |
|---|---|
 | |
| Synonyms | N/A |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Muscle weakness, fatigue, palpitations, paresthesia |
| Complications | Cardiac arrest, arrhythmia |
| Onset | Sudden or gradual |
| Duration | Variable |
| Types | N/A |
| Causes | Kidney failure, medications, acidosis, cellular breakdown |
| Risks | Diabetes, heart failure, chronic kidney disease |
| Diagnosis | Blood test for serum potassium |
| Differential diagnosis | Hypokalemia, pseudohyperkalemia |
| Prevention | Dietary management, medication review |
| Treatment | Calcium gluconate, insulin, beta-2 agonists, dialysis |
| Medication | N/A |
| Prognosis | Depends on underlying cause and treatment |
| Frequency | Common |
| Deaths | N/A |
Higher than normal levels of potassium in the circulating blood is called hyperkalemia and is associated with kidney failure or sometimes with the use of diuretic drugs.
File:Hyperkalemia.pdf
Causes[edit]
Potassium is a mineral that is needed for our cells to function properly which is normally obtained via food.
Role of kidneys[edit]
The kidneys remove excess potassium through the urine to keep a proper balance of this mineral in the body. When the kidneys are not working well, they may not be able to remove the proper amount of potassium leading to hyperkalemia. Some of the causes include:
- Addison disease -- Disease in which the adrenal glands do not make enough hormones, reducing the kidneys' ability to remove potassium from the body
- Burns over large areas of the body
- Some blood pressure lowering drugs, most often angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers
- Damage to muscle and other cells from certain street drugs, alcohol abuse, untreated seizures, surgery, crush injuries and falls, certain chemotherapy, or certain infections
- Disorders that cause blood cells to burst (hemolytic anemia)
- Severe bleeding from the stomach or intestines
- Taking extra potassium, such as salt substitutes or supplements
- Tumors
Symptoms[edit]
While it can be asymptomatic, some may experience the following symptoms:
- Nausea or vomiting
- Difficulty breathing
- Slow, weak, or irregular pulse
- Chest pain
- Palpitations
- Sudden collapse, when the heartbeat gets too slow or even stops
Tests[edit]
- Electrocardiogram (ECG)
- Blood potassium level
Treatment[edit]
- You will need emergency treatment if your potassium level is very high, or if you have danger signs, such as changes in your ECG.
- Emergency treatment may include:
- Calcium given into your veins (IV) to treat the muscle and heart effects of high potassium levels
- Glucose and insulin given into your veins (IV) to help lower potassium levels long enough to correct the cause
- Dialysis if your kidney function is poor
Other medicines
- Sodium bicarbonate if the problem is caused by acidosis
- Some diuretics that increase the excretion of potassium by your kidney
- Changes in your diet can help both prevent and treat high potassium levels.
Dietary changes[edit]
- Limit or avoid asparagus, avocados, potatoes, tomatoes or tomato sauce, winter squash, pumpkin, and cooked spinach
- Limit or avoid oranges and orange juice, nectarines, kiwifruit, raisins, or other dried fruit, bananas, cantaloupe, honeydew, prunes, and nectarines
- Limit or avoid taking salt substitutes if you are asked to follow a low-salt diet
- Your provider may make the following changes to your medicines:
- Reduce or stop potassium supplements
- Stop or change the doses of medicines you are taking, such as ones for heart disease and high blood pressure
- Take a certain type of water pill to reduce potassium and fluid levels if you have chronic kidney failure
- Follow your provider's directions when taking your medicines:
- DO NOT stop or start taking medicines without first talking to your provider
- Take your medicines on time
