What Is Hyperkalemia?

Hyperkalemia is a condition where the level of potassium in the blood is higher than normal. Potassium is an important mineral that helps nerves function and muscles, including the heart, to contract. However, too much potassium can be dangerous and may lead to serious heart problems.

What Causes Hyperkalemia?

Hyperkalemia can result from various factors, including:

• Kidney disease or failure, which impairs potassium excretion
• Medications that affect potassium balance, such as ACE inhibitors, ARBs, potassium-sparing diuretics, or NSAIDs
• Adrenal gland disorders like Addison’s disease
• Excessive potassium intake, especially through supplements
• Tissue damage, such as burns, trauma, or tumor lysis syndrome
• Uncontrolled diabetes or acidosis, which can shift potassium from cells into the bloodstream

What Are the Symptoms?

Mild hyperkalemia may not cause any symptoms. As potassium levels rise, symptoms may include:

• Muscle weakness or fatigue
• Numbness or tingling
• Nausea or vomiting
• Irregular heartbeat (palpitations)
• Chest pain or tightness
• In severe cases, it may lead to heart arrhythmias or cardiac arrest

How Is It Diagnosed?

Hyperkalemia is usually diagnosed through a blood test that measures potassium levels. Normal blood potassium levels range from about 3.5 to 5.0 mEq/L. Levels above 5.0 mEq/L may indicate hyperkalemia.

Additional tests may include:

• Electrocardiogram (ECG) to detect changes in heart rhythm
• Kidney function tests
• Blood pH and electrolytes to assess for acidosis

What Is the Treatment?

Treatment depends on the severity and cause of hyperkalemia. It may include:

• Stopping or adjusting medications that raise potassium
• Dietary changes to limit potassium intake
• Diuretics to help remove excess potassium through urine
• Medications such as sodium polystyrene sulfonate or patiromer to bind and eliminate potassium
• In emergencies:
  • Calcium gluconate to stabilize the heart
  • Insulin with glucose to shift potassium into cells
  • Dialysis in patients with kidney failure or dangerously high potassium levels

Are There Any Complications?

If untreated, hyperkalemia can cause:

• Severe heart rhythm problems
• Cardiac arrest
• Sudden death

Early diagnosis and prompt treatment are essential to prevent these serious outcomes.

What Is the Outlook?

The outlook for hyperkalemia depends on the underlying cause and how quickly it is treated. With proper management, most people recover fully. Chronic hyperkalemia may require ongoing monitoring and lifestyle adjustments.

Can Hyperkalemia Be Prevented?

Yes, especially in people at risk. Preventive steps include:

• Regular monitoring of potassium levels, especially in people with kidney disease or on certain medications
• Following dietary guidelines recommended by a healthcare provider
• Taking medications as prescribed and avoiding overuse of potassium supplements
• Staying hydrated and managing any underlying conditions