Definition of "Hyperkalemia"

Last modified: 14 hours



Hyperkalemia (from English "hyper" meaning "high", "kalium" meaning "potassium") is elevated concentration of the electrolyte potassium K+.

Patient information

What's hyperkalemia?
It's high potassium in blood.

Cause
  • Ineffective elimination, including:
    • Renal insufficiency
    • Drugs, that interfere w/ urinary excretion, including:
      • ACEi's and ARB's
      • Potassium-sparing diuretics, e.g. amiloride and spironolactone
      • NSAID's, e.g. ibuprofen, naproxen, celecoxib
      • Calcineurin inhibitor immunosuppressants ciclosporin and tacrolimus
      • Antibiotic trimethoprim
      • Antiparasitic drug pentamidine
    • MIneralocorticoid deficiency or resistance, e.g.:
      • Addison's disease
      • Aldosterone deficiency
      • Some forms of congenital adrenal hyperplasia
      • Type 4 renal tubular acidosis (resistance of renal tubules to aldosterone)
    • Gordon's syndrome (pseudohypoaldosteronism type 2)
  • Excessive release from cells, including:
    • Rhabdomyolysis, burns, or any cause of rapid tissue necrosis, including tumor lysis syndrome
    • Massive blood transfusion or massive hemolysis
    • Shifts/transport out of cells caused by:
      • Acidosis
      • Low insulin levels
      • Beta-blocker therapy
      • Digoxin overdose
      • Paralyzing agent succinylcholine
    • Box jellyfish venom
    • Acute digoxin toxicity, may cause hyperkalemia
  • Excessive intake, w/ potassium salt-substitute, potassium-containing dietary supplements, or potassium chloride (KCl) infusion
  • Pseudohyperkalemia, a rise in the amount of potassium that occurs due to excessive leakage of potassium from cells, during or after blood is drawn
Sx
  • Non-specific Sx
Dx
  • Blood test, usually performed for another reason
Tx
  • Calcium, as calcium chloride, calcium gluconate, or [calcium] resonium, to increase the threshold potential, thus restoring normal gradient between the threshold potential and the resting membrane potential, which is elevated abnormally in hyperkalemia
  • Removal of excess potassium is usually necessary, by:
    • Stimulating urine production
    • Through dialysis

Patient information

What can you do about high potassium in blood?
You can give calcium. Or you can also remove extra potassium, through increasing urination, and using an artificial kidney.

Complications
  • Potentially fatal arrhythmias (i.e. abnormal heart rhythms)
Prognosis
  • Extreme hyperkalemia is a medical EMERGENCY
See also
  • Hypokalemia (antonym, LOW concentration of potassium K+ in blood)

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Definition of Hyperkalemia | Autoprac


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