Hyperkalemia

Hyperkalemia
Electrocardiography showing precordial leads in hyperkalemia.
Classification and external resources
Specialty	Critical care medicine, nephrology
ICD-10	E87.5
ICD-9-CM	276.7
DiseasesDB	6242
MedlinePlus	001179
eMedicine	emerg/261
Patient UK	Hyperkalemia
MeSH	D006947
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Hyperkalemia, also spelled hyperkalaemia, is an elevated level of potassium (K⁺) in the blood serum. Normal potassium levels are between 3.5 and 5.0 mmol/L (3.5 and 5.0 mEq/L) with levels above 5.5 mmol/L defined as hyperkalemia. Typically this results in no symptoms. Occasionally when severe it results in palpitations, muscle pain, muscle weakness, or numbness. An abnormal heart rate can occur which can result in cardiac arrest and death.

Common causes include kidney failure, hypoaldosteronism, and rhabdomyolysis. A number of medications can also cause high blood potassium including spironolactone, NSAIDs, and angiotensin converting enzyme inhibitors. The severity is divided into mild (5.5-5.9 mmol/L), moderate (6.0-6.4 mmol/L), and severe (>6.5 mmol/L). High levels can also be detected on an electrocardiogram (ECG). Pseudohyperkalemia, due to breakdown of cells during or after taking the blood sample, should be ruled out.

Initial treatment in those with ECG changes is calcium gluconate. Medications that might worsen the condition should be stopped and a low potassium diet should be recommended. Other medications used include dextrose with insulin, salbutamol, and sodium bicarbonate. Measures to remove potassium from the body include furosemide, polystyrene sulfonate, and hemodialysis. Hemodialysis is the most effective method. The use of polystyrene sulfonate, while common, is poorly supported by evidence.

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