Hyperkalemia: Causes, Symptoms, and Treating High Potassium Levels

What is hyperkalemia?

Hyperkalemia is characterised by abnormally high levels of potassium in the bloodstream. The body normally maintains potassium within a narrow range of 3.5 to 5.0 milliequivalents per litre (mEq/L). When this balance is disrupted and potassium accumulates, it can interfere with various bodily functions, particularly affecting the heart and muscles.

What happens when potassium is high?

High potassium levels can alter the electrical activity of nerve and muscle cells, leading to:

• Muscle weakness or paralysis
• Tingling or numbness in the extremities
• Irregular heartbeat (arrhythmia)
• Nausea and vomiting

In severe cases, high potassium can cause the heart to stop beating suddenly, a life-threatening condition requiring emergency treatment.

What is a safe or normal potassium level?

For most adults, a normal serum potassium level falls between 3.5 and 5.0 mEq/L. Levels above 5.5 mEq/L are considered hyperkalemia, with readings over 6.0 mEq/L indicating severe elevation. However, the threshold for concern may be lower in people with certain health conditions or taking specific medications.

How common is hyperkalemia?

While not prevalent in the general population, hyperkalemia symptoms are more common among individuals with underlying health issues. According to a 2014 study, hyperkalemia affected approximately 3% of hospitalised patients. The incidence is higher in people with chronic kidney disease, with rates ranging from 5% to 50% depending on the stage of kidney dysfunction.

What are the symptoms of high potassium?

Mild hyperkalemia often presents no noticeable symptoms, but as potassium levels increase, hyperkalemia symptoms may include muscle weakness, cramps, and fatigue. You might also experience tingling in the hands and feet, nausea, and an irregular heartbeat.

In severe cases, high potassium can lead to paralysis, difficulty breathing, and cardiac arrest, necessitating immediate medical attention. If you notice any of these signs, which indicate hyperkalemia symptoms, it’s crucial to seek help promptly to prevent serious complications.

What are the causes of hyperkalemia?

Several factors can contribute to high potassium levels, also known as hyperkalemia, including:

• Kidney disease: Impaired kidney function significantly reduces potassium excretion, leading to accumulation.
• Medications: Certain drugs, such as ACE inhibitors and potassium-sparing diuretics, can raise potassium levels.
• Excessive potassium intake: Consuming too many potassium-rich foods or supplements can increase levels, especially in individuals with kidney issues.
• Addison's disease: This adrenal gland disorder disrupts the body's potassium regulation.
• Severe tissue damage: Conditions like burns, trauma, or rhabdomyolysis can cause potassium to leak into the bloodstream.
• Uncontrolled diabetes: High blood sugar combined with impaired kidney function can lead to hyperkalemia causes.

Understanding these factors can help in managing and preventing high potassium levels effectively.

Is hyperkalemia contagious?

No, hyperkalemia is not an infectious condition and cannot spread from person to person. It results from various medical factors and health conditions that disrupt the body's potassium balance.

Who does hyperkalemia affect?

While anyone can develop high potassium, certain groups are at higher risk:

• People with chronic kidney disease or kidney failure
• Individuals with type 1 diabetes, especially if poorly managed
• Those taking specific medications that affect potassium excretion
• People with adrenal gland disorders like Addison's disease
• Individuals who have experienced severe burns or crush injuries

Older adults and those with multiple chronic health conditions are also more susceptible to hyperkalemia.

What are the complications of hyperkalemia?

Untreated hyperkalemia can have serious consequences, such as:

• Cardiac arrhythmias, including ventricular fibrillation and cardiac arrest
• Muscle weakness or paralysis affecting respiratory muscles
• Metabolic acidosis (excessive acid in the blood)
• Kidney damage or failure

Timely diagnosis and appropriate hyperkalemia treatment are essential to prevent these potentially life-threatening complications.

How is hyperkalemia diagnosed?

If hyperkalemia is suspected based on symptoms or risk factors, the following tests may be performed:

• Blood tests: Measuring serum potassium levels is the primary diagnostic tool.
• Electrocardiogram (ECG): An ECG can detect changes in heart rhythm caused by high potassium.
• Urine tests: Analysing potassium excretion can help identify the underlying cause.
• Kidney function tests: Assessing kidney health is important, as impaired function often contributes to hyperkalemia.

How do you treat hyperkalemia?

Hyperkalemia treatment depends on the severity and underlying cause. Approaches may include:

• Dietary changes: Restricting high-potassium foods and avoiding potassium supplements.
• Medication adjustments: Stopping or changing drugs that contribute to high potassium.
• Potassium binders: Oral medications that bind to potassium in the gut and promote its excretion.
• Diuretics: Medications that increase urinary potassium excretion.
• Intravenous treatments: In severe cases, insulin, glucose, or calcium may be given to shift potassium into cells.
• Dialysis: For individuals with kidney failure, dialysis can effectively remove excess potassium.

Can hyperkalemia be prevented?

Preventing hyperkalemia involves managing underlying health conditions and being mindful of potassium intake. Strategies include:

• Monitoring kidney function and treating kidney disease
• Following a low-potassium diet as recommended by a healthcare provider
• Avoiding over-the-counter potassium supplements unless prescribed
• Staying hydrated to support potassium excretion
• Regularly reviewing medications with a doctor or pharmacist
• For people at high risk, close monitoring of potassium levels through regular blood tests is essential.

What can I expect if I have hyperkalemia?

If you are diagnosed with hyperkalemia, your healthcare team will work to identify and address the underlying cause. Hyperkalemia treatment will focus on lowering potassium levels and preventing complications. You may need to make dietary changes, adjust medications, and undergo regular monitoring. With proper management, most people with hyperkalemia can maintain stable potassium levels and avoid serious health issues.

What can we eat/drink with hyperkalemia?

If you have hyperkalemia, your doctor may recommend a low-potassium diet to help manage your condition. This typically involves avoiding or limiting high-potassium foods and consuming specific foods.

Foods to Avoid

• Fruits: Bananas, oranges, and melons
• Vegetables: Potatoes, sweet potatoes, and winter squash
• Leafy Greens: Spinach, Swiss chard, and beet greens
• Legumes: Beans, lentils, and nuts

Foods to Consume

• Fruits: Apples and berries
• Vegetables: Carrots and green beans
• Grains: White rice

Consulting with a registered dietitian can provide personalised guidance on managing potassium intake effectively.

When to see a doctor?

Seek immediate medical attention if you experience symptoms of severe hyperkalemia, such as:

• Muscle weakness or paralysis
• Difficulty breathing
• Chest pain or palpitations
• Confusion or fainting

If you have a condition that increases your risk of high potassium, discuss with your doctor how often to have your levels checked and what signs to watch for.

What is the difference between hyperkalemia and hypokalemia?

While hyperkalemia refers to high potassium levels, hypokalemia is the opposite - abnormally low potassium in the blood. Hypokalemia can cause muscle weakness, cramps, and arrhythmias, but it typically results from different causes, such as prolonged vomiting, diarrhoea, or certain diuretics. Both conditions require medical attention to restore proper potassium balance.

Conclusion

By understanding the causes, symptoms, and treatment options for hyperkalemia, you can work with your healthcare team to maintain healthy potassium levels and prevent complications. If you have concerns about your potassium or are at risk for hyperkalemia, don't hesitate to discuss testing and monitoring with your doctor.

Metropolis Healthcare, a leading chain of diagnostic labs across India, offers comprehensive pathology services, including potassium level testing, to support your health journey. With a team of skilled phlebotomists for at-home sample collection and advanced labs for accurate processing, Metropolis delivers reliable results and personalised care. Take charge of your well-being by staying informed and proactive about your health - early detection and management can make all the difference in navigating conditions like hyperkalemia.