Hyperkalemia: Symptoms and Treatments

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:

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:

 

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Symptoms of Hyperkalemia

Too much potassium in your blood can affect how your heart works. Symptoms of hyperkalemia can include:

Diagnosing Hyperkalemia

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 about 2,000 milligrams potassium per day
  • Stopping or changing meds that are contributing to the hyperkalemia.
  • Taking medicine to lower the potassium in your body
    1. Water pills (diuretics) to remove potassium via the urinary tract
    2. Sodium polystyrene sulfonate (Kayexalate) to remove potassium via the digestive tract
  • 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.

WebMD Medical Reference Reviewed by Melinda Ratini, DO, MS on August 30, 2018

Sources

SOURCES:

American Family Physician: "Hyperkalemia."

American Association of Clinical Chemistry: "Potassium: The Test."

Parham, W. Texas Heart Institute Journal, 2006; vol 33: pp 40-47.

National Heart Lung and Blood Institute: "Electrocardiogram."

Mount, D. "Disorders of potassium balance," in Brenner, B.M., ed., Brenner and Rector's The Kidney, 8th ed., Saunders Elsevier, 2008.

Ferri, F. Practice Guide to the Care of the Medical Patient, 8th ed., Mosby, 2010.

Gibbs, M. "Tayal VS. Electrolyte disturbances," in Marx, J, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice, 7th ed., Mosby Elsevier, 2009.

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