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Hyperkalemia

Overview

Potassium is an electrolyte (a mineral) that your body needs to function properly. Potassium is essential for your nerves, muscles, and heart. While potassium is important for good health, too much of it can be just as bad as not getting enough. Usually, your kidneys maintain a healthy potassium balance by excreting excess potassium from your body. However, the amount of potassium in your blood can become abnormally high for a variety of reasons. Hyperkalemia, or a high potassium level, is the medical term for this. Potassium levels in the blood should be between 3.6 and 5.2 millimoles per liter (mmol/L). Potassium levels greater than 5.5 mmol/L are considered critically high and levels greater than 6 mmol/L can be fatal. To avoid complications, whether you have mild or severe hyperkalemia, you should get medical help as soon as possible.

Causes

Kidney Failure: High potassium levels are most commonly caused by kidney failure. When your kidneys fail or stop working correctly, you won't be able to remove excess potassium from your body.

Certain Conditions: High potassium levels have also been linked to health conditions like dehydration, type 1 diabetes, Addison's disease, and internal bleeding.

Medications: High levels of potassium are also related to certain medications such as Angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers, and certain chemotherapy drugs.

Supplements: Taking too many potassium supplements might cause your potassium levels to rise to dangerously high levels.

Alcohol or drug abuse: Excessive alcohol or drug abuse can induce muscular breakdown. This breakdown can cause a large amount of potassium to leak into your blood from your muscle cells.

Trauma: Certain types of trauma can also cause an increase in potassium levels. The excess potassium is leaked from body cells into your circulation in these cases. These effects can be caused by burns or crush injuries that involve a large number of muscle cells.

Signs and Symptoms

 If your potassium levels are high enough, you may experience the following symptoms:

  • Weakness or fatigue
  • Tingling or feeling of numbness
  • Vomiting or nausea
  • Difficulty breathing
  • Pain in the chest
  • Irregular heartbeats or palpitations

High potassium levels may result in paralysis or heart failure in extreme cases. High potassium levels may cause your heart to stop if left untreated.

Diagnosis

 Hyperkalemia can be diagnosed via a blood test or a urine test. Your doctor will perform routine blood tests during your annual checkup or if you've recently started a new medication. These tests will identify any issues with your potassium levels. It's important to have regular checks if you're at risk for high potassium levels. This is because you may not realize you have a high potassium level until symptoms appear.

Treatment

The most common goal of treatment for excessive potassium levels is to help your body quickly remove the excess potassium and stabilize your heart.

Hemodialysis is the best treatment option if you have high potassium levels due to kidney failure. When your kidneys cannot filter your blood adequately, hemodialysis uses a machine to remove waste from your blood, including excess potassium.

Medications

Medications to treat high potassium levels may be prescribed by your doctor. These may include the following:

Calcium gluconate: Calcium gluconate can help minimize potassium’s effect on your heart until high potassium levels are normalized.

Diuretics: These medications make you urinate more frequently. Some diuretics increase the quantity of potassium excreted by the kidneys, whereas others don't. Your doctor may prescribe one or more diuretics, depending on your potassium levels, such as loop diuretics, potassium-sparing diuretics, or thiazide diuretics.

Resin: You may be given a resin medication to take by mouth in some cases. The resin binds to potassium and allows it to pass through your body during bowel movements.

Prognosis

If you're at risk for high potassium, you should get regular blood testing because symptoms don't often show up right away. If you have high potassium levels, your doctor will choose the best treatment strategy based on your blood tests. Your doctor may recommend hospitalization or dialysis if your levels are alarmingly high. If your potassium levels are somewhat raised, and you don't have any other signs or symptoms of hyperkalemia, your doctor may choose to monitor you and request a follow-up test. High potassium can be managed in either case with prompt intervention.

Our clinical experts continually monitor the health and medical content posted on CURA4U, and we update our blogs and articles when new information becomes available. Last reviewed by Dr.Saad Zia on May 21, 2023.

References

Hyperkalemia (high potassium) - Symptoms, causes, diagnosis, and treatment | National Kidney Foundation

https://www.kidney.org/atoz/content/what-hyperkalemia

Hyperkalemia - StatPearls - NCBI Bookshelf (nih.gov)

https://www.ncbi.nlm.nih.gov/books/NBK470284/#:~:text=Hyperkalemia%20is%20defined%20as%20a,%2C%20muscle%20weakness%2C%20or%20paralysis.

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