Hyperkalemia

What is Hyperkalemia?

Hyperkalemia is a serious condition in which excess amount of potassium are in the bloodstream. Potassium is necessary for cell metabolism, muscle contraction and electrical-impulse transmission of the muscles. Adequate amounts are found in foods such as bananas, orange juice, baked potatoes, fish, beans and dairy products. Any excesses are usually flushed out through elimination. When this does not occur and potassium levels build up, the result can be muscle paralysis, heart problems and, in severe cases, death.

Hyperkalemia is found most often in individuals with kidney problems, aldosterone deficiency, and diabetes. It can also develop in individuals taking oral potassium supplements to lower blood pressure, as a complication of severe skin burns, internal bleeding and trauma, and as a reaction to drugs that interfere with potassium absorption and excretion.

How is it diagnosed?

History: Individuals may complain of nausea, diarrhea, confusion and general weakness. If the disorder has progressed, they may notice muscle paralysis or heart palpitations.

Physical exam: Findings include poor reflexes, a slow or irregular heartbeat, slurred speech and restlessness. In severe hyperkalemia, the individual may exhibit signs of numbness, and respiratory or cardiac arrest.

Tests: Blood tests will confirm the diagnosis. An EKG (electrocardiogram) may be ordered to determine any impact on the heart.

How is Hyperkalemia treated?

When hyperkalemia is the result of a drug complication, removing the offending drug will usually correct the problem. In most cases, however, individuals are given intravenous drug therapy that may include insulin, sodium bicarbonate, calcium salts, dextrose, sodium polystyrene sulfonate, and diuretics. If the individual's condition does not improve, hemodialysis may be necessary. (Individuals already on hemodialysis are usually given nebulizer treatments containing albuterol as treatment for their condition. ) Once individuals are stabilized, they are usually advised to watch their intake of potassium-rich foods.

Medications

Aldactone (Spironolactone), Proventil (Albuterol)

What might complicate it?

Hyperkalemia can be complicated when individuals take blood pressure medications and for those who have kidney disease, diabetes or heart problems. Undiagnosed and untreated, it can lead to muscle paralysis and heart and kidney failure.

Predicted outcome

Most individuals respond favorably to treatment.

Alternatives

Hyperkalemia can be a sign of adrenal insufficiency and hypoaldosteronism.

Appropriate specialists

Internist and hematologist.

Last updated 8 August 2015