High potassium (hyperkalemia)

Originally Published: February 26, 1999 - Last Updated / Reviewed On: September 14, 2012
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Dear Alice,

I would like to know what you would do when your potassium level is high. And what could cause this? Please let me know.

Dear Reader,

Hyperkalemia, also known as high potassium or hyperpotassemia, is a condition resulting from abnormally high levels of potassium in the blood. A person is at a higher risk for hyperkalemia if s/he has too much potassium in his or her diet (such as from using salt substitutes). In addition, certain medications, like diuretics that conserve potassium (i.e., spironolactone, amiloride, or triameterene) and intravenous potassium supplementation may also result in hyperkalemia.

Potassium is used by the body for muscle contraction, enzyme reactions, and maintenance of normal pH and water balance, and may possibly regulate blood pressure levels. Our kidneys help maintain normal potassium balance in the blood by filtration, reabsorption, and excretion of excess potassium in the urine with the aid of the hormone aldosterone. However, if a person’s potassium-balancing processes become impaired, or if a person’s kidneys fail to work properly, then s/he may develop hyperkalemia.

If you think you're at risk for hyperkalemia and experience any of the following symptoms, it is important that you visit your health care provider immediately. Hyperkalemia can be a serious, and possibly life-threatening, condition if not treated in time. Hyperkalemia can cause:

  • Weakness
  • Abnormal body sensations
  • Paralysis
  • Irregular heartbeat
  • Weak, slow pulse rate
  • Difficulty breathing

There are many different treatment plans for hyperkalemia. Treatment varies, depending on the causes of your condition, the severity of your symptoms, and how the condition is affecting your organs (including your kidneys and heart). One or more of the following treatments may be beneficial to help manage your high potassium levels:

  • Maintaining a low-potassium diet (this is generally only used in mild cases)
  • Stopping any use of medications that increase blood potassium levels
  • Administering glucose and insulin intravenously — this helps potassium travel from the extracellular space back into the cells
  • Having intravenous calcium administered to temporarily protect the heart and muscles from the effects of hyperkalemia
  • Taking medications that stimulate beta-2 adrenergic receptors, such as albuterol and epinephrine — these medications can help push potassium back into cells
  • Taking cation-exchange resin medications — these bind to potassium and help it leave the body through the gastrointestinal tract
  • Dialysis treatments, particularly if other treatment options have been unsuccessful, or if the patient is experiencing renal (kidney) failure

If you think you have hyperkalemia, it is important that you speak with your health care provider. Based on your health care provider’s evaluation, s/he will recommend an appropriate treatment plan for you.

Alice