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Treatments for High Blood Potassium (Hyperkalemia)

Reviewed by Brunilda Nazario, MD on December 15, 2020

Too much potassium in your blood, a condition called hyperkalemia, can happen suddenly or because of an ongoing condition like kidney disease. But hyperkalemia can affect your heart and other parts of your body, so it’s important to treat it.

Emergency Treatments

These medications include:

  • IV insulin and glucose
  • IV calcium
  • IV sodium bicarbonate
  • Inhaled albuterol

They start working in minutes by shifting potassium out of the blood and into cells.

People with very high blood potassium levels may also need dialysis, which uses a special machine to filter the potassium from your blood.

Maintenance Medications

Importance of TreatmentA nephrologist breaks down hyperkalemia and its effect on your kidneys.111

[MUSIC PLAYING]

HAROLD FRANCH: Hyperkalemia is

having a high level of potassium

in the blood.

Potassium is a common mineral

found in a variety of foods.

And it's essential for life.

A slight increase

in the potassium level

is not dangerous at all.

But a greater increase can lead

the heart to stop and muscles

to get paralyzed.



The body actually uses salts

like potassium to create

the electricity that moves

through the body.

And so if you disrupt the amount

of potassium, if you change it,

then that changes the amount

of electricity generated.



Hyperkalemia is usually caused

by either decreased kidney

function

or by changes in the hormones

that control potassium

in the body.

There are common blood pressure

drugs that effect

these hormones.

And they are the most common

cause of hyperkalemia.

Another common cause are

over-the-counter pain medicines.



The main treatment option

is to stop the medicine that

caused the hyperkalemia.

If that is not enough,

you can use other medicines,

such as diuretics and sodium

bicarbonate--

the mineral that's in baking

soda.



Finally, there are

potassium-binding drugs that

directly remove potassium

from the body.

There are no symptoms

of the condition until it

becomes life-threatening.

So it's very important

that if your potassium is high

that you keep it under control.

Harold Franch, MD/delivery/53/e2/53e2c1ca-9194-4443-ad1a-a9cbb2e61af6/funded-expert-feature-hyperkalemia_,2500k,1000k,4500k,750k,400k,.mp403/01/2019 12:00:00650350illustration of kidneys/webmd/consumer_assets/site_images/article_thumbnails/video/hyperkalemia_expert_video/650x350_hyperkalemia_expert_video.jpg091e9c5e81bcda69

Even if hyperkalemia isn’t a crisis, you still need to get your potassium levels down.

Some medications lower potassium slowly, including:

  • Water pills (diuretics), which rid the body of extra fluids and remove potassium through urine
  • Sodium bicarbonate, which temporarily shifts potassium into body cells
  • Albuterol, which raises blood insulin levels and shifts potassium into body cells
  • Sodium polystyrene sulfonate (Kayexalate), which removes potassium through your intestines before it’s absorbed
  • Patiromer (Veltassa), which binds to potassium in the intestines
  • Sodium zirconium cyclosilicate (Lokelma), which binds to potassium in the intestines

 

Adjusting Other Medications, Diet

Your doctor will look at whether you need to stop taking other medications in order to lower your blood potassium levels, or adjust how much you take. That happens because these drugs contribute to higher potassium.

These medications include:

  • NSAIDs (nonsteroidal anti-inflammatory drugs) such as the pain relievers aspirin, ibuprofen, and naproxen
  • High blood pressure drugs. Some can block a hormone that controls potassium levels.
  • Herbal supplements. Ask your doctor about which ones might be a hidden source of potassium.
  • Potassium supplements

Too much potassium in foods can also contribute to higher levels in your blood if your kidneys don’t work well. So your doctor will ask you about what you eat and drink, and then give you advice on what things you may need to cut back on because they have a lot of potassium.

Dialysis Treatments

Your kidneys help control the balance of potassium in your body, and if they don’t work properly they can’t do that important job. So you might need dialysis to treat your kidney disease -- which also treats hyperkalemia.

WebMD Medical Reference

Sources

SOURCES:

Cleveland Clinic: “Hyperkalemia (High Blood Potassium).”

Medscape: “Hyperkalemia in Emergency Medicine.”

Cleveland Clinic Journal of Medicine: “Diagnosis and Treatment of Hyperkalemia.”

U.S. Pharmacist: “Updated Treatment Options in the Management of Hyperkalemia.”

The New England Journal of Medicine: “Sodium Zirconium Cyclosilicate in Hyperkalemia.”

Vascular Risk Health Management: “Blocking the RAAS at Different Levels.”

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