Table of ContentsView AllTable of ContentsCommon CausesGeneticsCardiovascularLifestyle Risk FactorsFrequently Asked QuestionsNext in Hyperkalemia GuideHow Hyperkalemia Is Diagnosed
Table of ContentsView All
View All
Table of Contents
Common Causes
Genetics
Cardiovascular
Lifestyle Risk Factors
Frequently Asked Questions
Next in Hyperkalemia Guide
Hyperkalemiais the medical term for blood potassium levels that are too high. Potassium is a chemical element that is essential for life. It’s especially important for the normal functioning of organ systems that rely on the transmission of electrical signals—the heart, muscles, and the nerves.
There are many factors and illnesses that cancause hyperkalemiaincluding kidney disease,heart failure, diabetes mellitus, and certain medications. In adults, a normal potassium blood level is between 3.6 and 5.2 mEq/L.Potassium levels that are either too low (hypokalemia) or too high can become life-threatening problems.
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There are numerous potential causes ofhyperkalemia, but they can be broken down into three major categories.
Decreased Excretion of Potassium
Because the maintenance of normal potassium levels is critical to life, our kidneys have efficient mechanisms for hanging on to potassium to prevent our levels from being too low, and also for excreting excess potassium in urine to prevent our levels from being too high.
In people who haveacute kidney failureorchronic kidney disease, the ability of the kidneys to excrete potassium may become impaired, which can cause hyperkalemia.
Before the days ofdialysis, hyperkalemia was a frequent cause of death in people with kidney disease.
A decrease in the kidney’s excretion of potassium may also occur with:
Certain medications that affect therenin-aldosterone systemcan also decrease the kidney’s ability to excrete potassium. They include:
What Are Potassium-Sparing Diuretics?Potassium-sparing diuretics are medications that result in sodium and water elimination from the body through urine production—and without the loss of potassium. They are commonly used to treat high blood pressure.
What Are Potassium-Sparing Diuretics?
Potassium-sparing diuretics are medications that result in sodium and water elimination from the body through urine production—and without the loss of potassium. They are commonly used to treat high blood pressure.
Increased Potassium Release From the Cells
Because the concentration of potassium inside of your body’s cells is roughly 30 times higher than it is in your blood, anything that causes an increased release of potassium from inside the cells into the bloodstream can lead to hyperkalemia.Potassium levels are measured using a blood test.
When your body contains too much acid, called acidosis, such as withdiabetic ketoacidosis, potassium is moved out of your cells and can produce significant and potentially life-threatening hyperkalemia.
Excessive Intake of Potassium
If you have normally functioning kidneys, it’s pretty difficult to develop hyperkalemia simply from ingesting too much potassium in your diet. However, it is possible to drive blood potassium levels too high if you take large amounts of potassium supplements, especially if you also have some degree of kidney disease or if you’re taking drugs that inhibit potassium excretion like the ones mentioned above.
There are two rare hereditary disorders that can cause hyperkalemia. These can both be diagnosed with genetic testing.
Pseudohypoaldosteronism Type 1
Pseudohypoaldosteronismtype 1 (PHA1) makes it hard for your body to regulate sodium, which mainly occurs in your kidneys. There are two types of PHA1:
This latter disorder can lead to hyperkalemia because high amounts ofsodiumare released into your urine, causing low levels of sodium and high levels of potassium in your blood. In fact, hyperkalemia is considered one of the main features of this disorder.
Pseudohypoaldosteronism Type 2
Pseudohypoaldosteronism type 2 (PHA2), also known as Gordon’s syndrome, is another hereditary condition that causes hyperkalemia. This disorder makes it difficult for your body to regulate both sodium and potassium, resulting inhigh blood pressureand hyperkalemia, yet normal kidney function. Hyperkalemia tends to occur first, while high blood pressure develops later.
Heart failure is considered one of the causes of hyperkalemia, as are some of the medications that people with heart failure often take, including diuretics, ACE inhibitors, and beta blockers.Because of this, if you have heart failure and you’re taking any of these life-saving medications, you may need to limit the amount of potassium you have in your diet to help reduce the risk of developing hyperkalemia. It is also likely that your healthcare provider will closely monitor the potassium levels in your blood and minimize the number of medications you’re taking that can increase potassium levels.
If you have diabetes mellitus, among the many reasons why it’s important to get your disease under control is the risk of developing hyperkalemia, which can lead to death if it becomes severe.When diabetes mellitus is poorly controlled or uncontrolled, you end up with too much glucose in your bloodstream. This creates an insulin deficiency that can lead to hyperkalemia and other life-threatening problems. Be sure to work with your healthcare provider to find atreatment programthat works for you in controlling your blood glucose so you can reduce your risks of serious and potentially life-threatening effects.
Summary
Hyperkalemia is an electrolyte disorder where the body has too much potassium in the blood. This can be potentially dangerous. Risk factors and conditions that can cause high potassium levels include certain medications, impaired kidney function, heart failure, insulin deficiency, eating a diet high in potassium, and more. Rare hereditary disorders, known as PHA1 and PHA2, are other known causes.
If you have risk factors for hyperkalemia, it’s important to follow your healthcare provider’s instructions regarding medications and diet to avoid dangerously high potassium levels.
Frequently Asked QuestionsElevated potassium typically doesn’t cause obvious symptoms, so hyperkalemia often isn’t diagnosed until it shows up during testing for some other condition. That said, the symptoms of hyperkalemia, which may easily be mistaken for other health conditions, are:NauseaNumbnessMuscle weaknessDiarrheaStomach crampsWhen there is too much potassium—and/or sodium—circulating in the body, it can interfere with the electrical signals in the myocardium, which is the thick layer of muscle in the middle of the heart. The result can be irregular heart rhythms.Usually only if you’re at risk for hyperkalemia. In that case, limiting or eliminating certain foods may help to prevent it from developing, including:AsparagusAvocadosBananasCantaloupeCooked spinachDried fruitHoneydewKiwifruitNectarinesOranges and orange juicePotatoesPumpkinTomatoes or tomato sauceWinter squash
Elevated potassium typically doesn’t cause obvious symptoms, so hyperkalemia often isn’t diagnosed until it shows up during testing for some other condition. That said, the symptoms of hyperkalemia, which may easily be mistaken for other health conditions, are:NauseaNumbnessMuscle weaknessDiarrheaStomach cramps
Elevated potassium typically doesn’t cause obvious symptoms, so hyperkalemia often isn’t diagnosed until it shows up during testing for some other condition. That said, the symptoms of hyperkalemia, which may easily be mistaken for other health conditions, are:
When there is too much potassium—and/or sodium—circulating in the body, it can interfere with the electrical signals in the myocardium, which is the thick layer of muscle in the middle of the heart. The result can be irregular heart rhythms.
Usually only if you’re at risk for hyperkalemia. In that case, limiting or eliminating certain foods may help to prevent it from developing, including:AsparagusAvocadosBananasCantaloupeCooked spinachDried fruitHoneydewKiwifruitNectarinesOranges and orange juicePotatoesPumpkinTomatoes or tomato sauceWinter squash
Usually only if you’re at risk for hyperkalemia. In that case, limiting or eliminating certain foods may help to prevent it from developing, including:
How Hyperkalemia Is Diagnosed
7 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Cleveland Clinic.Hyperkalemia (high blood potassium).Kovesdy CP.Updates in hyperkalemia: Outcomes and therapeutic strategies.Rev Endocr Metab Disord.2017;18(1):41-47. doi:10.1007/s11154-016-9384-xNational Institutes of Health: Office of Dietary Supplements.Potassium.MedlinePlus.Pseudohypoaldosteronism type 1.MedlinePlus.Pseudohypoaldosteronism type 2.National Kidney Foundation.Hyperkalemia (high potassium).American Heart Association.Hyperkalemia (high blood potassium).Additional ReadingMayo Clinic.High potassium (hyperkalemia).Mount DB.Causes and evaluation of hyperkalemia in adults. UpToDate.Sterns RH, Rojas M, Bernstein P, Chennupati S.Ion-exchange resins for the treatment of hyperkalemia: are they safe and effective?Journal of the American Society of Nephrology. May 2010;21(5):733–5. doi:10.1681/ASN.2010010079
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Cleveland Clinic.Hyperkalemia (high blood potassium).Kovesdy CP.Updates in hyperkalemia: Outcomes and therapeutic strategies.Rev Endocr Metab Disord.2017;18(1):41-47. doi:10.1007/s11154-016-9384-xNational Institutes of Health: Office of Dietary Supplements.Potassium.MedlinePlus.Pseudohypoaldosteronism type 1.MedlinePlus.Pseudohypoaldosteronism type 2.National Kidney Foundation.Hyperkalemia (high potassium).American Heart Association.Hyperkalemia (high blood potassium).Additional ReadingMayo Clinic.High potassium (hyperkalemia).Mount DB.Causes and evaluation of hyperkalemia in adults. UpToDate.Sterns RH, Rojas M, Bernstein P, Chennupati S.Ion-exchange resins for the treatment of hyperkalemia: are they safe and effective?Journal of the American Society of Nephrology. May 2010;21(5):733–5. doi:10.1681/ASN.2010010079
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Cleveland Clinic.Hyperkalemia (high blood potassium).Kovesdy CP.Updates in hyperkalemia: Outcomes and therapeutic strategies.Rev Endocr Metab Disord.2017;18(1):41-47. doi:10.1007/s11154-016-9384-xNational Institutes of Health: Office of Dietary Supplements.Potassium.MedlinePlus.Pseudohypoaldosteronism type 1.MedlinePlus.Pseudohypoaldosteronism type 2.National Kidney Foundation.Hyperkalemia (high potassium).American Heart Association.Hyperkalemia (high blood potassium).
Cleveland Clinic.Hyperkalemia (high blood potassium).
Kovesdy CP.Updates in hyperkalemia: Outcomes and therapeutic strategies.Rev Endocr Metab Disord.2017;18(1):41-47. doi:10.1007/s11154-016-9384-x
National Institutes of Health: Office of Dietary Supplements.Potassium.
MedlinePlus.Pseudohypoaldosteronism type 1.
MedlinePlus.Pseudohypoaldosteronism type 2.
National Kidney Foundation.Hyperkalemia (high potassium).
American Heart Association.Hyperkalemia (high blood potassium).
Mayo Clinic.High potassium (hyperkalemia).Mount DB.Causes and evaluation of hyperkalemia in adults. UpToDate.Sterns RH, Rojas M, Bernstein P, Chennupati S.Ion-exchange resins for the treatment of hyperkalemia: are they safe and effective?Journal of the American Society of Nephrology. May 2010;21(5):733–5. doi:10.1681/ASN.2010010079
Mayo Clinic.High potassium (hyperkalemia).
Mount DB.Causes and evaluation of hyperkalemia in adults. UpToDate.
Sterns RH, Rojas M, Bernstein P, Chennupati S.Ion-exchange resins for the treatment of hyperkalemia: are they safe and effective?Journal of the American Society of Nephrology. May 2010;21(5):733–5. doi:10.1681/ASN.2010010079
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