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
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 or venom (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)
Symptoms of Hyperkalemia
Too much potassium in your blood can affect how your heart works. Symptoms of hyperkalemia can include:
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.
Treatment for Hyperkalemia
Treatment may include:
- Low potassium diet consisting of consists of about 2,000 milligrams to 3,000 milligrams potassium per day
- Stopping or changing meds that are contributing to the hyperkalemia.
- Taking medicine to lower the potassium in your body
- Water pills (diuretics) to remove potassium via the urinary tract
- Sodium polystyrene sulfonate (Kayexalate) to remove potassium via the digestive tract
- Patiromer (Veltassa) to reduce the levels of blood potassium
- Treat your kidney disease, which may include dialysis which filters potassium from your blood.
Other treatments depend on the cause of hyperkalemia. If you have a dangerously high potassium level you will get emergency care including IV medications.
Complications of Hyperkalemia
Hyperkalemia is a common cause of life-threatening heart rhythm changes, or cardiac arrhythmias. It can lead to an emergency condition called ventricular fibrillation. In this condition, the lower parts of your heart flutter rapidly instead of pumping blood.
Untreated, an extremely high amount of potassium in your blood can make your heart stop beating, causing death.