Hyperkalemia

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Obesity, Sleep & Internal medicine
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Hyperkalemia
ECG changes in 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.

Cause of hyperkalemia

Causes

Potassium is a mineral that is needed for our cells to function properly which is normally obtained via food.

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. 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

Hyperkalemia ECG

Symptoms

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

ECG in hyperkalemia

Tests

• Electrocardiogram (ECG)
• Blood potassium level

ECG demonstrating hyperkalemia with absent P waves

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.
• 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

• 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