Definition

What is hyperkalemia?

Hyperkalemia is the medical term that describes a potassium level in your blood that’s higher than normal. Potassium is a chemical that is critical to the function of nerve and muscle cells, including those in your heart.

Your blood potassium level is normally 3.6 to 5.2 millimoles per liter (mmol/L). Having a blood potassium level higher than 6.0 mmol/L can be dangerous and usually requires immediate treatment.

How common is hyperkalemia?

Hyperkalemia is a common diagnosis. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of hyperkalemia?

Hyperkalemia can be asymptomatic, meaning that it causes no symptoms. Sometimes, patients with hyperkalemia report vague symptoms including:

More serious symptoms of hyperkalemia include slow heartbeat and weak pulse. Severe hyperkalemia can result in fatal cardiac standstill (heart stoppage). Generally, a slowly rising potassium level (such as with chronic kidney failure) is better tolerated than an abrupt rise in potassium levels. Unless the rise in potassium has been very rapid, symptoms of hyperkalemia are usually not apparent until potassium levels are very high (typically 7.0 mEq/l or higher).

Symptoms may also be present that reflect the underlying medical conditions that are causing the hyperkalemia.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes hyperkalemia?

Often a report of high blood potassium isn’t true hyperkalemia. Instead, it may be caused by the rupture of blood cells in the blood sample during or shortly after the blood draw. The ruptured cells leak their potassium into the sample. This falsely raises the amount of potassium in the blood sample, even though the potassium level in your body is actually normal. When this is suspected, a repeat blood sample is done.

The most common cause of genuinely high potassium (hyperkalemia) is related to your kidneys, such as:

  • Acute kidney failure
  • Chronic kidney disease

Other causes of hyperkalemia include:

  • Addison’s disease (adrenal failure)
  • Angiotensin-converting enzyme (ACE) inhibitors
  • Angiotensin II receptor blockers
  • Beta blockers
  • Dehydration
  • Destruction of red blood cells due to severe injury or burns
  • Excessive use of potassium supplements
  • Type 1 diabetes

Risk factors

What increases my risk for hyperkalemia?

Please discuss with your doctor for further information.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is hyperkalemia diagnosed?

Hyperkalemia can be difficult to diagnose. The symptoms can be mild and may be due to many different health problems.

Your doctor will examine you and listen to your heart beat. You will be asked questions about your medical history, diet, and use of medications. It is important to make sure your doctor knows about all the medicines you are taking, including over-the-counter products such as herbs and other supplements.

Lab tests may be done to check the level of potassium in your blood and urine. Blood test results vary from lab to lab. Your doctor will explain your specific results. Many different factors can affect your potassium level. If your potassium level appears high, your doctor will likely repeat the blood test.

An electrocardiogram, called ECG or EKG, will be done to check for problems with your heart rhythm. This test records your heart’s electrical activity.

Not every person with hyperkalemia has changes that can be seen on an ECG. Sometimes, changes that are seen may be mistakenly attributed to another disease.

How is hyperkalemia treated?

Treatment of hyperkalemia must be individualized based upon the underlying cause of the hyperkalemia, the severity of symptoms or appearance of ECG changes, and the overall health status of the patient. Mild hyperkalemia is usually treated without hospitalization especially if the patient is otherwise healthy, the ECG is normal, and there are no other associated conditions such as acidosis and worsening kidney function. Emergency treatment is necessary if hyperkalemia is severe and has caused changes in the ECG. Severe hyperkalemia is best treated in the hospital, oftentimes in the intensive care unit, under continuous heart rhythm monitoring.

Treatment of hyperkalemia may include any of the following measures, either singly or in combination:

  • A diet low in potassium (for mild cases).
  • Discontinue medications that increase blood potassium levels.
  • Intravenous administration of glucose and insulin, which promotes movement of potassium from the extracellular space back into the cells.
  • Intravenous calcium to temporarily protect the heart and muscles from the effects of hyperkalemia.
  • Sodium bicarbonate administration to counteract acidosis and to promote movement of potassium from the extracellular space back into the cells.
  • Diuretic administration to decrease the total potassium stores through increasing potassium excretion in the urine. It is important to note that most diuretics increase kidney excretion of potassium. Only the potassium-sparing diuretics mentioned above decrease kidney excretion of potassium.
  • Medications that stimulate beta-2 adrenergic receptors, such as albuterol and epinephrine, have also been used to drive potassium back into cells.
  • Medications known as cation-exchange resins, which bind potassium and lead to its excretion via the gastrointestinal tract.
  • Dialysis, particularly if other measures have failed or if renal failure is present.

Treatment of hyperkalemia also includes treatment of any underlying causes (for example, kidney disease, adrenal disease, tissue destruction) of hyperkalemia

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage hyperkalemia?

Please discuss with your doctor for further information.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: December 27, 2017 | Last Modified: December 27, 2017