Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatmentComplicationsWhen to See a Healthcare ProviderFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
Complications
When to See a Healthcare Provider
Frequently Asked Questions
Hyperkalemiais anelectrolytedisorder where a person has too muchpotassiumin the blood. Electrolytes are minerals (like sodium and potassium) that carry an electrical charge. Hyperkalemia can lead to life-threatening problems with electrical conduction in the heart.
People with chronic kidney disease, diabetes, heart failure, and those taking certain blood pressure medicines are most at risk for hyperkalemia.However, everyone needs to recognize potential symptoms associated with the problem.
Learn more about the symptoms, causes, and treatment of hyperkalemia (too much potassium). Only a healthcare provider can diagnose this electrolyte disorder, so learn when you need to seek care.
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Symptoms of Hyperkalemia
The symptoms of hyperkalemia are often nonspecific if present at all. Therefore, most people will not know they have hyperkalemia unless regular laboratory testing is performed. However, this is usually only done in people at risk for hyperkalemia.
When a person develops symptoms, it is usually because of one of two reasons: the potassium level is very high, or the potassium rose very rapidly. Symptoms can include:
Genetic Hyperkalemia Disorder
The most severe manifestation of hyperkalemia is cardiac conduction abnormalities that lead to a heart rhythm problem. This can lead to:
The likelihood of having such a problem depends on a person‘s risk for hyperkalemia (chronic kidney disease), level of hyperkalemia (higher than 6.5 milliequivalents per liter is very concerning), and how quickly the potassium rises (a rapid rise is problematic).
Symptoms of High Potassium (Hyperkalemia)
Causes of Hyperkalemia
However, it is difficult to know how common the disease is since many people will not have symptoms until the potassium level is concerningly high.
Hyperkalemia in a Healthy PersonA person without risks for hyperkalemia can develop life-threatening hyperkalemia after a significant crush injury, such as in a major motor vehicle collision. The crushed cells rapidly release potassium into the blood, and the swift rise can lead to cardiac conduction problems.
Hyperkalemia in a Healthy Person
A person without risks for hyperkalemia can develop life-threatening hyperkalemia after a significant crush injury, such as in a major motor vehicle collision. The crushed cells rapidly release potassium into the blood, and the swift rise can lead to cardiac conduction problems.
People with chronic kidney disease or who take medications that affect kidney function are at the highest risk for hyperkalemia. The specific conditions that put people at risk for the electrolyte disorder include:
Causes and Risk Factors of Hyperkalemia
Diet RecommendationsA diet low in potassium is recommended for individuals at risk for hyperkalemia (people with chronic kidney disease).
Diet Recommendations
A diet low in potassium is recommended for individuals at risk for hyperkalemia (people with chronic kidney disease).
What Medications Can Cause Hyperkalemia?
People who take certain medications are at higher risk of developing hyperkalemia. These medications include:
Do Not Stop Your MedicinesIf you take an antihypertensive (for high blood pressure) medication that might lead to hyperkalemia, do not stop taking it without speaking to your healthcare provider.Although some medications may increase your risk for hyperkalemia, these medicines show significant overall survival benefits when used appropriately in people with chronic heart failure, hypertension, or diabetes.
Do Not Stop Your Medicines
If you take an antihypertensive (for high blood pressure) medication that might lead to hyperkalemia, do not stop taking it without speaking to your healthcare provider.Although some medications may increase your risk for hyperkalemia, these medicines show significant overall survival benefits when used appropriately in people with chronic heart failure, hypertension, or diabetes.
If you take an antihypertensive (for high blood pressure) medication that might lead to hyperkalemia, do not stop taking it without speaking to your healthcare provider.
Although some medications may increase your risk for hyperkalemia, these medicines show significant overall survival benefits when used appropriately in people with chronic heart failure, hypertension, or diabetes.
Are There Tests to Diagnose the Cause of Hyperkalemia?
Hyperkalemia isdiagnosedthrough a blood test that measures your electrolytes. An abnormally high potassium level is generally considered to be higher than 5.0 milliequivalents per liter (mEq/L). However, some people may not have any symptoms at this or even higher levels (greater than 6.5 milliequivalents per liter).
PseudohyperkalemiaIt is common for a person’s blood level of potassium to be elevated erroneously. This is called pseudohyperkalemia, resulting from fist clenching while your blood is being drawn or a poor blood drawing technique. Therefore, your healthcare provider may request you to have a repeat test before treatment is initiated.
Pseudohyperkalemia
It is common for a person’s blood level of potassium to be elevated erroneously. This is called pseudohyperkalemia, resulting from fist clenching while your blood is being drawn or a poor blood drawing technique. Therefore, your healthcare provider may request you to have a repeat test before treatment is initiated.
Once a blood test shows that a person has hyperkalemia, a healthcare provider is likely to perform anelectrocardiogram(ECG). This test evaluates the heart’s electrical system using electrodes placed on your chest.
Hyperkalemia can lead to life-threatening electrical problems in the heart and abnormal rhythms. A healthcare provider needs to determine whether the hyperkalemia is already leading to concerning electrical changes. If so, treatment of hyperkalemia becomes emergent rather than urgent.
How to Treat Hyperkalemia
Treatment will depend on whether there is acute or chronic hyperkalemia.
Acute Hyperkalemia
The treatment of hyperkalemia can depend on how high the potassium is and whether the change has happened quickly or gradually.It can also depend on whether the potassium level is beginning to affect your heart. Therefore, a healthcare provider may perform an ECG to look for electrical problems.
The decision to treat a high potassium level rests with a healthcare provider, especially since the diagnosis cannot be made unless blood tests are performed. Generally, a serum potassium level greater than 5.5 milliequivalents per liter is a threshold for treatment.
People With Chronic Kidney Disease Can Tolerate a Higher PotassiumPeople with chronic kidney disease, especially those ondialysis, seem to tolerate a higher potassium level than those without chronic kidney disease.Experts think that these people develop “resistance” to higher potassium levels since they are likely to have moderately high levels regularly. Therefore, they are less likely to develop symptoms or cardiac problems when the potassium level is mild-to-moderately elevated.
People With Chronic Kidney Disease Can Tolerate a Higher Potassium
People with chronic kidney disease, especially those ondialysis, seem to tolerate a higher potassium level than those without chronic kidney disease.Experts think that these people develop “resistance” to higher potassium levels since they are likely to have moderately high levels regularly. Therefore, they are less likely to develop symptoms or cardiac problems when the potassium level is mild-to-moderately elevated.
People with chronic kidney disease, especially those ondialysis, seem to tolerate a higher potassium level than those without chronic kidney disease.
Experts think that these people develop “resistance” to higher potassium levels since they are likely to have moderately high levels regularly. Therefore, they are less likely to develop symptoms or cardiac problems when the potassium level is mild-to-moderately elevated.
When a healthcare provider is concerned about a rapid rise in potassium or if an individual has ECG changes, emergency treatment will be initiated and will first stabilize the heart. The most critical medication at this point in treatment iscalcium gluconateor calcium chloride. This medication specifically stabilizes the electricity in the heart.
Additional treatments that will commence include:
Hyperkalemia
Chronic Hyperkalemia
People with chronic hyperkalemia are challenging to spot because they are usually asymptomatic.Often, chronic hyperkalemia is only detected through regular laboratory testing.
The treatment for chronic hyperkalemia also includes hemodialysis or certain diuretics, but typically healthcare providers modify the dose or type of antihypertensive medication that is potentially leading to chronic hyperkalemia.
However, another alternative is to use medications that bind to potassium and eliminate it through the gastrointestinal tract. These potassium binders allow your healthcare provider to keep you on beneficial antihypertensive medications while treating chronic hyperkalemia. These medications include:
Risks and Benefits of Newer MedicinesVeltassa and Lokelma are new agents that can be pretty expensive. However, research studies have shown that when these medications are used to treat hyperkalemia in people with chronic heart failure, the benefits outweigh the financial costs.
Risks and Benefits of Newer Medicines
Veltassa and Lokelma are new agents that can be pretty expensive. However, research studies have shown that when these medications are used to treat hyperkalemia in people with chronic heart failure, the benefits outweigh the financial costs.
Complications and Risk Factors Associated With Hyperkalemia
There are no major chronic long-term complications associated with hyperkalemia. However, people with repeated episodes of hyperkalemia are at higher risk of dying from the electrolyte problem that can lead to cardiac arrest.
Generally, the people at the highest risk for death from hyperkalemia are those with multiple medical issues or those who are critically ill in the hospital.
Hyperkalemia often does not lead to symptoms, so knowing when to seek care can be challenging.
However, if you develop severe generalized weakness or have difficulty moving your lower extremities, there is a chance you have an electrolyte problem. In this situation, you should seek care for further testing to evaluate for hyperkalemia along with a whole host of other medical problems.
People with risk factors for hyperkalemia should follow their healthcare provider’s instructions regarding medications and diet to avoid dangerous potassium levels.
Summary
Hyperkalemia is an electrolyte disorder where the body has too much potassium. Symptoms are often lacking, but some people can develop muscle cramps and extreme weakness.
The most common cause of hyperkalemia is chronic kidney disease, but people who take certain antihypertensive medications are also at risk for the problem. Hyperkalemia can only be diagnosed through a blood test.
Treating acute hyperkalemia is life-saving and includes medications that stabilize the heart and remove potassium from the body. Knowing if you have hyperkalemia can be challenging, so it’s vital to seek care when you feel extreme weakness. Furthermore, people at risk for hyperkalemia should have regular blood checks.
A Word From Verywell
Hyperkalemia in healthy people is rare. However, if you feel extreme weakness or muscle cramps, you could have any electrolyte disorder, including hyperkalemia. Therefore, you should seek care.
If you are at risk for hyperkalemia based on your underlying medical problems or medications, discuss regular testing with your healthcare provider to ensure a proper potassium level.
Frequently Asked QuestionsThere are no home tests that can be performed to evaluate for hyperkalemia.Foods high in potassium include winter squash, bananas, lentils, spinach, broccoli, avocado, oranges, cantaloupe, and dried fruits, such as raisins, dates, and prunes.Learn MoreLow-Potassium DietYes. Hyperkalemia can develop if cells in your body are rapidly damaged (like in a crush injury). Other instances when this might occur include:Extreme physical exercise or weight liftingTumor lysis syndrome related to cancerExtreme heat illnessUse of sympathomimetic drugs (stimulants that increase heart rate and blood pressure) like cocaineLearn MoreAn Overview of Tumor Lysis Syndrome
There are no home tests that can be performed to evaluate for hyperkalemia.
Foods high in potassium include winter squash, bananas, lentils, spinach, broccoli, avocado, oranges, cantaloupe, and dried fruits, such as raisins, dates, and prunes.Learn MoreLow-Potassium Diet
Foods high in potassium include winter squash, bananas, lentils, spinach, broccoli, avocado, oranges, cantaloupe, and dried fruits, such as raisins, dates, and prunes.
Learn MoreLow-Potassium Diet
Yes. Hyperkalemia can develop if cells in your body are rapidly damaged (like in a crush injury). Other instances when this might occur include:Extreme physical exercise or weight liftingTumor lysis syndrome related to cancerExtreme heat illnessUse of sympathomimetic drugs (stimulants that increase heart rate and blood pressure) like cocaineLearn MoreAn Overview of Tumor Lysis Syndrome
Yes. Hyperkalemia can develop if cells in your body are rapidly damaged (like in a crush injury). Other instances when this might occur include:Extreme physical exercise or weight liftingTumor lysis syndrome related to cancerExtreme heat illnessUse of sympathomimetic drugs (stimulants that increase heart rate and blood pressure) like cocaine
Yes. Hyperkalemia can develop if cells in your body are rapidly damaged (like in a crush injury). Other instances when this might occur include:
Learn MoreAn Overview of Tumor Lysis Syndrome
5 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.Palmer BF, Carrero JJ, Clegg DJ, et al.Clinical management of hyperkalemia.Mayo Clin Proc. 2021;96(3):744-762. doi:10.1016/j.mayocp.2020.06.014Genetic and Rare Diseases Information Center.Hyperkalemic periodic paralysis.Viera AJ, Wouk N.Potassium disorders: hypokalemia and hyperkalemia.Am Fam Physician. 2015;92(6):487-495.Montford JR, Linas S.How dangerous is hyperkalemia?J Am Soc Nephrol. 2017;28(11):3155-3165. doi:10.1681/ASN.2016121344Bounthavong M, Butler J, Dolan CM, et al.Cost-effectiveness analysis of patiromer and spironolactone therapy in heart failure patients with hyperkalemia.Pharmacoeconomics. 2018;36(12):1463-1473. Erratum in:Pharmacoeconomics. 2019. doi:10.1007/s40273-018-0709-3
5 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.Palmer BF, Carrero JJ, Clegg DJ, et al.Clinical management of hyperkalemia.Mayo Clin Proc. 2021;96(3):744-762. doi:10.1016/j.mayocp.2020.06.014Genetic and Rare Diseases Information Center.Hyperkalemic periodic paralysis.Viera AJ, Wouk N.Potassium disorders: hypokalemia and hyperkalemia.Am Fam Physician. 2015;92(6):487-495.Montford JR, Linas S.How dangerous is hyperkalemia?J Am Soc Nephrol. 2017;28(11):3155-3165. doi:10.1681/ASN.2016121344Bounthavong M, Butler J, Dolan CM, et al.Cost-effectiveness analysis of patiromer and spironolactone therapy in heart failure patients with hyperkalemia.Pharmacoeconomics. 2018;36(12):1463-1473. Erratum in:Pharmacoeconomics. 2019. doi:10.1007/s40273-018-0709-3
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.
Palmer BF, Carrero JJ, Clegg DJ, et al.Clinical management of hyperkalemia.Mayo Clin Proc. 2021;96(3):744-762. doi:10.1016/j.mayocp.2020.06.014Genetic and Rare Diseases Information Center.Hyperkalemic periodic paralysis.Viera AJ, Wouk N.Potassium disorders: hypokalemia and hyperkalemia.Am Fam Physician. 2015;92(6):487-495.Montford JR, Linas S.How dangerous is hyperkalemia?J Am Soc Nephrol. 2017;28(11):3155-3165. doi:10.1681/ASN.2016121344Bounthavong M, Butler J, Dolan CM, et al.Cost-effectiveness analysis of patiromer and spironolactone therapy in heart failure patients with hyperkalemia.Pharmacoeconomics. 2018;36(12):1463-1473. Erratum in:Pharmacoeconomics. 2019. doi:10.1007/s40273-018-0709-3
Palmer BF, Carrero JJ, Clegg DJ, et al.Clinical management of hyperkalemia.Mayo Clin Proc. 2021;96(3):744-762. doi:10.1016/j.mayocp.2020.06.014
Genetic and Rare Diseases Information Center.Hyperkalemic periodic paralysis.
Viera AJ, Wouk N.Potassium disorders: hypokalemia and hyperkalemia.Am Fam Physician. 2015;92(6):487-495.
Montford JR, Linas S.How dangerous is hyperkalemia?J Am Soc Nephrol. 2017;28(11):3155-3165. doi:10.1681/ASN.2016121344
Bounthavong M, Butler J, Dolan CM, et al.Cost-effectiveness analysis of patiromer and spironolactone therapy in heart failure patients with hyperkalemia.Pharmacoeconomics. 2018;36(12):1463-1473. Erratum in:Pharmacoeconomics. 2019. doi:10.1007/s40273-018-0709-3
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