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Hyperkalemia: Symptoms and Treatments

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If you have hyperkalemia, you have too much potassium in your blood. The body needs a delicate balance of potassium to help the heart and other muscles work properly. But too much potassium in your blood can lead to dangerous, and possibly deadly, changes in heart rhythm.

Causes of Hyperkalemia

Hyperkalemia -- high potassium in your blood -- may occur if your kidneys do not work properly and cannot remove potassium from your body or if your body's cells release too much potassium.

Kidney disease is the most common cause of hyperkalemia. Your kidneys help control the balance of potassium in your body. If they do not work properly, they cannot filter extra potassium from the blood or remove it from the body. A hormone called aldosterone tells the kidneys when to remove potassium -- as well as sodium. Diseases that decrease the production of this hormone, such as Addison's disease, can lead to hyperkalemia.

Excess potassium in the diet can also contribute to increased levels in your blood, especially if there is an issue with kidney function. Salt substitutes typically contain high amounts of potassium. Foods such as melons, orange juice, and bananas are rich in potassium too.

Some health problems interfere with how potassium moves out of the body's cells. Sometimes, cells release too much potassium. Releasing too much potassium can result from:

  • Breakdown of red blood cells, called hemolysis
  • Breakdown of muscle tissue, called rhabdomyolysis
  • Burns, trauma, or other tissue injury
  • Uncontrolled diabetes

Conditions that can affect the kidney's ability to remove potassium from the body include:

  • Hormonal disorders
  • Lupus
  • Kidney failure
  • Other kidney diseases


Drug-Induced Hyperkalemia

Certain medications can also make it harder for the kidneys to remove potassium. This is particularly true if you have kidney disease or problems with the way your body handles potassium. Also, some drugs may increase the amount of potassium in the body.

Medications that have been linked to hyperkalemia include:

  • Antibiotics, including penicillin G and trimethoprim.
  • Azole antifungals, used to treat vaginal yeast infections and other fungal infections.
  • Blood pressure drugs called angiotensin-converting enzyme (ACE) inhibitors.
  • Blood pressure drugs called angiotensin-receptor blockers (ARBs), although they are less likely than ACE inhibitors to increase potassium levels.
  • Blood pressure drugs called beta-blockers.
  • Herbal supplements, including milkweed, lily of the valley, Siberian ginseng, Hawthorn berries, or preparations from dried toad skin (Bufo, Chan Su, Senso).
  • Heparin, a blood thinner.
  • Nonsteroidal anti-inflammatory medications (NSAIDs).
  • Potassium supplements.
  • Potassium-sparing diuretics, including triamterene, amiloride (Midamor), and spironolactone (Aldactone).


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