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 Renal Disease

Hyperkalemia

Hyperkalemia

Circulatory system
Circulatory system

Definition:

Hyperkalemia is a condition caused by higher-than-normal levels of potassium in the bloodstream.

Alternative Names:
High potassium; Potassium - high
Causes, incidence, and risk factors:

Potassium is involved in regulating muscle tissue, and is part of digestion, metabolism, and homeostasis (maintaining a balance between the many electrical and chemical processes of the body).

Hyperkalemia occurs when the level of potassium in the bloodstream is higher than normal. This may be related to an increase in total body potassium or the excess release of potassium from the cells into the bloodstream.

The kidneys normally remove excess potassium from the body. Therefore, most cases of hyperkalemia are caused by disorders that reduce the kidneys' ability to excrete potassium.

Insufficient kidney function may result from disorders such as:

The hormone aldosterone regulates kidney removal of sodium and potassium. Lack of aldosterone can result in hyperkalemia with an increase in total body potassium. Addison's disease is one disorder that causes reduced aldosterone production.

Any time potassium is released from the cells, it may build up in the fluid outside the cells and in the bloodstream. Acidosis leads to the movement of potassium from inside the cells to the fluid outside the cells.

Tissue trauma causes the cells to release potassium. This trauma includes:

If the kidney is working properly, and there is enough aldosterone, tissue trauma alone rarely leads to hyperkalemia. A normally functioning kidney will remove the excess potassium that has been released from the cells.

Increased intake of potassium can cause hyperkalemia if kidney function is poor. Salt substitutes often contain potassium, as do many "low-salt" packaged foods.

Hyperkalemia may be caused by medications, including medications that affect kidney function (potassium sparing diuretics, such as spironolactone, amiloride, or triamterene) and potassium supplements (especially intravenous potassium).

Symptoms:

Hyperkalemia often has no symptoms. Occasionally, people may have the following symptoms:

Signs and tests:
  • ECG may show changes related to hyperkalemia
  • ECG may show potentially dangerous arrhythmias:
    • Heart block that may become a complete heart block
    • Slower-than-normal heartbeat (bradycardia) that progressively slows
    • Ventricular fibrillation
  • Pulse may be slow or irregular
  • Serum potassium is high

Review Date: 11/12/2007
Reviewed By: Charles Silberberg, D.O., Private Practice specializing in Nephrology, Affiliated with NY Medical College, Division of Nephrology, Valhalla, NY. Review provided by VeriMed Healthcare Network.

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