What is Hyperkalemia (High Potassium)?
Hyperkalemia (high potassium) describes elevated levels of potassium within the fluid part of blood (serum). Sudden rises in the mineral, or levels which are very high can be life threatening and need immediate emergency medical care. (1)
Potassium is an essential nutrient which our body needs to help nerves and muscles work efficiently. It also assists movement of nutrients into cells, and the elimination of waste products from cells.
Too much potassium in the blood causes many health issues, including heart palpitations and irregular heartbeats. (2)
Normal levels of potassium in the blood are measured at between three and a half and five. Anything over five is considered elevated, while over six and a half could be life threatening. (3)
Often people with hyperkalemia (high potassium) will experience no symptoms (asymptomatic). It might only be detected during a routine blood test for something else. But when they are present they include:
When we use our muscles, as they contract potassium is released from cells into the blood. Between contractions (when they rest) potassium is taken back up from the blood by the cells. This keeps potassium levels balanced. (4)
When potassium levels are elevated it creates imbalances and the muscles don’t work properly. They might feel weak tingly and numb, in extreme cases, they can even become paralyzed. (5)
While it’s common to feel tired now and again, when we are fatigued the feeling is overwhelming and persistent. A constant sense of lethargy and lack of energy are associated with this condition.
Nausea and Vomiting
Potassium and sodium play key roles in the functioning of heart muscle tissues. Their concentration levels are therefore maintained by the body.
When an imbalance occurs due to a rise in potassium levels, the ability of the heart to beat at a normal rhythm is affected. This manifests as an irregular heartbeat (arrhythmia).
Other symptoms relating to the heart include palpitations, fainting due to a loss of blood pressure and, at worst, sudden cardiac death. (10)
We have mentioned that hyperkalemia (high potassium) can be asymptomatic. It is also not common, affecting about five percent of the general population. (11)
There are several factors that can predispose you to have high potassium levels. These include:
The kidneys play a key role in maintaining potassium levels in the blood. They balance the amount of potassium uptake against the amount excreted.
Potassium is obtained from the foods we eat and the liquids we drink. The kidneys act as a filter and excess potassium is removed via urine. Early stage kidney disease usually deals with higher potassium levels, but as it progresses their function becomes impaired.
Insufficient potassium is removed from the body and causes hyperkalemia (high potassium). (12)
People with diabetes are either not able to produce insulin or don’t use it efficiently. Insulin helps the body metabolise glucose. The body’s ability to use potassium and glucose are also interrelated.
A lack of insulin can predispose someone to hyperkalemia (high potassium). In fact, this condition occurs more in people with diabetes than in the general population. (13)
Congestive Heart Failure
Congestive heart failure is a condition where the heart is inefficient and consequently insufficient oxygen is supplied to the body.
One of the drugs used to treat this condition is known as an aldosterone receptor antagonist. This medication reduces the body’s ability to remove excess potassium via the kidneys.
The tendency to develop a hyperkalemic state is therefore increased. (14)
There are many drugs which can affect the way the body is able to deal with potassium. These include drugs used to lower blood pressure or thin the blood, as well as drugs used to deal with heart failure.
Other drugs that can play a part are NSAIDs, used to treat pain and fever, and immunosuppressants, used for arthritis. (15)
There are other less common considerations that can lead to hyperkalemia (high potassium). These include: major injuries which cause muscle damage, extensive burns, blood transfusions, HIV, alcohol or drug abuse. (16)
Hyperkalemia (high potassium) is diagnosed by measuring the amount of potassium in the blood. When levels reach between eight and ten cardiac arrest is likely.
There are no stages associated with hyperkalemia (high potassium) there are however three main causes that can be assessed.
Increased Potassium Intake
We have mentioned that we obtain potassium from food and drink. While this is an uncommon cause in healthy adults, it can affect those with kidney issues.
Potassium is very high in foods like nuts, seaweed, dried fruits, avocado, molasses and lima beans. Vegetables that contain high levels of potassium include mangoes, oranges, kiwis, bananas, and cantaloupe melon. Red meats are also a rich source of potassium.
When your body processes potassium normally, high quantities of these foods should not pose a problem. However, when there are underlying conditions predisposing someone to hyperkalemia (high potassium) they should be avoided.
Intracellular Potassium Shifts
Damaged cells in the body can cause them to release potassium in large quantities into the blood. This leads to the potential risk of hyperkalemia (high potassium).
Excessive exercise, crush injuries or other things which damage red blood cells can cause a condition called rhabdomyolysis. The muscles release damaged cells and fibers into the bloodstream which can affect kidney function leading to hyperkalemia (high potassium).
Increased levels of acid in the body (metabolic acidosis) due to sepsis, dehydration or insufficient blood volume also lead to potassium imbalance.
Lack of insulin production and other medications can also contribute to elevated potassium levels.
Impaired Potassium Excretion
The ability of the kidneys to eliminate potassium from the body is also a key factor. When they are not filtering potassium efficiently levels can rise.
Decreased blood volume due to bleeding, low blood circulation due to cirrhosis, congestive heart failure or dehydration also contribute.
Another hormone, aldosterone, produced by the adrenal gland, also interferes with the elimination of potassium if it is deficient in the body. (17)
When blood samples are taken from the body, the blood cells might release potassium into the sample. This can give a false reading indicating hyperkalemia (high potassium) which is not actually present.
It is important for medical professionals to rule this out before treatment. (18)
The treatment of this condition will depend on the cause and severity of it. Blood tests to determine the levels of potassium and electrocardiogram (EKG) readings will be obtained.
If the levels are high, above six and a half, or the EKG indicates changes then immediate treatment will be given to lower potassium levels.
This could involve supplying calcium through an IV drip to treat the adverse effects on the heart and muscles. Glucose and insulin can reduce the levels of potassium for a short period so causes can be identified.
Other medicines are able to help excretion of potassium like diuretics. Kidney dialysis might also be an option if the kidneys are failing. (19)
When the EKG indicates no changes and kidney disease is the cause of hyperkalemia then treatment will consist of medications and dietary changes or advice. Medication might include diuretics and powders to help bind excess potassium in the bowels, for excretion in urine or feces. (20)
What is hyperkalemia (high potassium)? Hyperkalemia (high potassium) describes levels of potassium in the fluid part of blood (serum) which are elevated.
What are the signs of hyperkalemia (high potassium)? Signs indicating this condition, when they are present, include fatigue, weakness, heart palpitations or arrhythmia. Abdominal pain, nausea and diarrhea are further signs of hyperkalemia (high potassium).
How do you develop hyperkalemia (high potassium)? Medical conditions like kidney disease, congestive heart failure and diabetes as well as certain medications contribute to this condition.
How are you diagnosed for hyperkalemia (high potassium)? Blood tests and electrocardiogram readings indicate elevated levels of potassium.
What is the best treatment for hyperkalemia (high potassium)? Treatment will depend on the severity of the condition. However, very high levels of potassium are dangerous and require emergency treatment.
What are the long term complications of hyperkalemia (high potassium)? Mild hyperkalemia (high potassium) generally doesn’t cause lasting damage. Sudden onset or extreme cases in about two thirds of cases can be life threatening if not treated quickly. (21)
Is hyperkalemia (high potassium) considered a disability? Hyperkalemia (high potassium) does not appear to be classified as a disability, however some of the underlying conditions might be.
Is there a cure for hyperkalemia (high potassium)? Most cases of this condition can be successfully managed with dietary changes and medication.
Is hyperkalemia (high potassium) life threatening? When the onset is sudden and the potassium levels are very high, yes, this is a life threatening condition.
Hyperkalemia (high potassium) is a potentially life threatening condition as a result of high potassium levels in the blood.
It affects a small percentage of the general population and there are usually underlying causes. Thankfully, most cases can be treated and managed successfully.