Hyperkalemia

An Overview

Hyperkalemia is a high level of potassium in your blood. Potassium helps control how your muscles, heart, and digestive system work. 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. Potassium helps your nerves and muscles, including your heart, work the right way. But too much potassium in your blood can be dangerous. It can cause serious heart problems.

Extremely high levels of potassium in the blood (severe hyperkalemia) can lead to cardiac arrest and death. When not recognized and treated properly, severe hyperkalemia results in a high mortality rate.

Normal blood levels of potassium are critical for maintaining normal heart electrical rhythm. Both low blood potassium levels (hypokalemia) and high blood potassium levels (hyperkalemia) can lead to abnormal heart rhythms.

Causes for Hyperkalemia

Hyperkalemia can happen if your kidneys don’t work properly and cannot remove potassium from your body or if you take certain medicines. Kidney disease is the most common cause of hyperkalemia. Your kidneys help control the balance of potassium in your body. If they don’t work well, they can’t filter extra potassium from the blood or remove it from the body. Potassium shifting out of cells into the blood circulation and medications.
Some health problems interfere with how potassium moves out of the body’s cells. Sometimes, cells release too much potassium.

  • Breakdown of red blood cells, called hemolysis.
  • Kidney Disease. Hyperkalemia can happen if your kidneys do not work well. It is the job of the kidneys to balance the amount of potassium taken in with the amount lost in urine. Potassium is taken in through the foods you eat and the liquids you drink.
  • Intense and prolonged exercise.
  • Beta blockers.
  • Medical conditions, such as diabetes, HIV, tuberculosis or kidney disease.
  • Drugs that prevent the kidneys from losing enough potassium. Some drugs can keep your kidneys from removing enough potassium.
  • Breakdown of muscle tissue, called rhabdomyolysis.
  • Medicines, such as pain medicine and heart or blood pressure medicine.
  • A diet that is high in potassium.  Eating too much food that is high in potassium can also cause hyperkalemia, especially in people with advanced kidney disease.
  • Trauma, such as muscle injury, burns or surgery.
  • Destruction of red blood cells due to severe injury or burns.

Symptoms for Hyperkalemia

Many people have few, if any, symptoms. If symptoms do appear, they are usually mild and non-specific

  • Muscle weakness is a common symptom of hyperkalemia, in which a person experiences the inability to produce a normal muscle contraction by putting his or her full effort.
  • Nausea is another most commonly present symptom in the patients of hyperkalemia in which a person feels the urge to vomit.
  • Muscle cramps or pain
  • Numbness
  • Diarrhea
  • Fatigue. Fatigue usually occurs due to the reason of higher potassium levels, causing abnormalities in the function of muscles in our body.
  • Abdominal pain
  • Numbness or weakness. As we know that potassium levels in blood higher than their normal levels adversely affect the muscle functioning of our heart, and this increase then ultimately results in improper breathing.
  • Shortness of breath.
  • Tingling sensations.

More serious symptoms of hyperkalemia include slow heartbeat and weak pulse. Severe hyperkalemia can result in fatal cardiac standstill (heart stoppage).

Diagnosis

  • An EKG test records your heart rhythm and how fast your heart beats. It is used to check for irregular heartbeats.
  • Blood tests are done to check your potassium level.
  • The ECG will also be able to identify cardiac arrhythmias that result from hyperkalemia.

Treatment

You may need to follow a low-potassium diet. Your healthcare provider will tell you if any changes in your medicines are needed. You should not take salt substitutes, which are high in potassium. In normal individuals, healthy kidneys can adapt to excessive oral intake of potassium by increasing urine excretion of potassium, thus preventing the development of hyperkalemia. Emergency treatment is necessary if hyperkalemia is severe and has caused changes in the ECG. Severe hyperkalemia is best treated in the hospital, oftentimes in the intensive care unit, under continuous heart rhythm monitoring.

  • Mild hyperkalemia in a healthy individual may be treated on an outpatient basis.
  • Medicines will be given to remove potassium from your body. This will lower your potassium levels. This medicine may be given as a pill or an enema.
  • A diet low in potassium (for mild cases).
  • Discontinue medications that increase blood potassium levels.
  • Water pills (diuretics) help rid your body of extra potassium. They work by making your kidney create more urine. Potassium is normally removed through urine.
  • Medications that stimulate beta-2 adrenergic receptors, such as albuterol and epinephrine, have also been used to drive potassium back into cells.
  • Potassium binders often come in the form of a powder. They are mixed with a small amount of water and taken with food.
  • Dialysis may be needed if other treatments do not work. Dialysis uses a machine to remove waste products and toxins from your blood. Ask your healthcare provider for more information about dialysis.

Treatment of hyperkalemia also includes treatment of any underlying causes (for example, kidney disease, adrenal disease, tissue destruction) of hyperkalemia. Medications may be used to help lower the potassium level and to protect the body from the effects of hyperkalemia, such as heart rhythm disturbances.

Prevention

To prevent Hyperkalemia or High Potassium, making sure that your kidney is working properly is the best idea. However, eating low potassium diet to maintain the balance of potassium in the body is also not a bad idea.

  • It is not possible to prevent the majority of causes of hyperkalemia.
  • However, maintaining a healthy lifestyle and following your healthcare professional’s instructions for management of any chronic medical conditions can help slow or prevent progression of many diseases that may be associated with hyperkalemia.

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