Hyperkalemia

Hyperkalemia is an elevated level of <a href="/facts/Potassium/5lcumVgo">potassium</a> (K+) in the <a href="/facts/Serum_(blood)/a22tvug9">blood</a>. Normal potassium levels are between 3.5 and 5.0 <a href="/facts/Molar_concentration/P2WL5b9q">mmol/L</a> (3.5 and 5.0 <a href="/facts/Equivalent_(chemistry)/ksgd425g">mEq/L</a>) with levels above 5.5 mmol/L defined as hyperkalemia. Typically hyperkalemia does not cause symptoms. Occasionally when severe it can cause <a href="/facts/Palpitations/2wACMY49">palpitations</a>, <a href="/facts/Muscle_pain/AbVybHB8">muscle pain</a>, <a href="/facts/Muscle_weakness/4atjuBIl">muscle weakness</a>, or <a href="/facts/Paresthesia/hRBAxluk">numbness</a>. Hyperkalemia can cause an <a href="/facts/Heart_arrhythmia/ooEpr46Q">abnormal heart rhythm</a> which can result in <a href="/facts/Cardiac_arrest/HIAm9AWX">cardiac arrest</a> and death.
Common causes of hyperkalemia include <a href="/facts/Kidney_failure/gsqb5nos">kidney failure</a>, <a href="/facts/Hypoaldosteronism/o7G1lXT7">hypoaldosteronism</a>, and <a href="/facts/Rhabdomyolysis/Cs08YHfR">rhabdomyolysis</a>. A number of medications can also cause high blood potassium including mineralocorticoid receptor antagonists (e.g., <a href="/facts/Spironolactone/uauzo7MM">spironolactone</a>, <a href="/facts/Eplerenone/xJBzeEvm">eplerenone</a> and <a href="/facts/Finerenone/21Y1V5Jj">finerenone</a>) <a href="/facts/Nonsteroidal_anti-inflammatory_drug/coIkzl4s">NSAIDs</a>, <a href="/facts/Potassium-sparing_diuretic/EE4LqJgw">potassium-sparing diuretics</a> (e.g., <a href="/facts/Amiloride/JlcLDbvd">amiloride</a>), <a href="/facts/Angiotensin_II_receptor_blocker/152pCs2x">angiotensin receptor blockers</a>, and <a href="/facts/Angiotensin_converting_enzyme_inhibitors/cHT1Yxub">angiotensin converting enzyme inhibitors</a>. The severity is divided into mild (5.5 – 5.9 mmol/L), moderate (6.0 – 6.5 mmol/L), and severe (> 6.5 mmol/L). High levels can be detected on an <a href="/facts/Electrocardiography/YpVswJ0W">electrocardiogram</a> (ECG), though the absence of ECG changes does not rule out hyperkalemia. The measurement properties of ECG changes in predicting hyperkalemia are not known. Pseudohyperkalemia, due to breakdown of <a href="/facts/Cell_(biology)/bLM9UQvy">cells</a> during or after taking the blood sample, should be ruled out.
Initial treatment in those with ECG changes is salts, such as <a href="/facts/Calcium_gluconate/ErtaRtbU">calcium gluconate</a> or <a href="/facts/Calcium_chloride/e1EwNPGF">calcium chloride</a>. Other medications used to rapidly reduce blood potassium levels include <a href="/facts/Insulin/oXG0myt1">insulin</a> with <a href="/facts/Glucose/oUSkoLCD">dextrose</a>, <a href="/facts/Salbutamol/s5KYCt8j">salbutamol</a>, and <a href="/facts/Sodium_bicarbonate/S9oSol0R">sodium bicarbonate</a>. Medications that might worsen the condition should be stopped, and a low-potassium diet should be started. Measures to remove potassium from the body include diuretics such as <a href="/facts/Furosemide/tq9Lx0u4">furosemide</a>, potassium-binders such as <a href="/facts/Polystyrene_sulfonate/wfgeTdAh">polystyrene sulfonate</a> (Kayexalate) and <a href="/facts/Sodium_zirconium_cyclosilicate/mhreQDCW">sodium zirconium cyclosilicate</a>, and <a href="/facts/Hemodialysis/oB7fIKP7">hemodialysis</a>. Hemodialysis is the most effective method.
Hyperkalemia is rare among those who are otherwise healthy. Among those who are hospitalized, rates are between 1% and 2.5%. It is associated with an increased mortality, whether due to hyperkalaemia itself or as a marker of severe illness, especially in those without <a href="/facts/Chronic_kidney_disease/4YKH9wpo">chronic kidney disease</a>. The word hyperkalemia comes from hyper- 'high' + kalium 'potassium' + <a href="/facts/List_of_medical_roots%2c_suffixes_and_prefixes/0jVDvfru">-emia 'blood condition'</a>.

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Hyperkalemia