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Next in Hyperkalemia Guide
Potassium is one of the most common chemical elements in our bodies, mostly existing inside our cells. Hyperkalemiais the term for high potassium levels in your blood. A normalpotassiumlevel for adults is considered 3.6 to 5.2 mEq/L.
Verywell / Joshua Seong
1:50An Overview of Hyperkalemia
1:50
An Overview of Hyperkalemia
Understanding Electrolytes
To better understand why potassium levels are important and what may cause them to increase or decrease, it’s helpful to know how electrolytes function in the body.Most people are familiar with electrolytes from Gatorade or Pedialyte commercials that stress rehydration after exercise (or vomiting and diarrhea in Pedialyte’s case) to balance our electrolyte levels. While the information contained in the commercials is factual, it doesn’t even begin to define the complexity of electrolytes and how critical they are to your body.
In the most simple terms, electrolytes are compound minerals that when dissolved in water separate into electrically charged ions. There are many types of electrolytes, but sodium, potassium, chloride, bicarbonate, calcium, sulfate, magnesium, and phosphate are considered the most important in the human body. Our bodies depend on potassiumto regulate blood pressure, vascular tone, the normal function of insulin and various other hormones, gastrointestinal motility, acid-base balance, kidney function, and fluid and electrolyte balance.
Through hormones, specialized mechanisms, and transporters, the kidneys are responsible for monitoring the concentration and volume of electrolytes and water in the body. A basic example of how thekidneys regulate water and electrolytesis urination.When your body has excess fluid, your urine output is increased. When your body is dehydrated, your urine output is decreased. Any excess of electrolytes is expelled from your body through urine, sweat, and the digestive tract.
The kidneys have a strict margin of what is considered a low or high level of water or electrolytes in the body. When levels increase or decrease, the kidneys begin responding immediately. Experiencing thirst is a basic example of how our bodies respond to decreased water levels.
High potassium blood levels can disrupt the way certain organ systems function and can become fatal if left untreated. Because hyperkalemia can become quite dangerous, elevated potassium levels must be taken seriously, even if they are not yet producing any symptoms.
Hyperkalemia Symptoms
Potassium plays an important role in heart and neuromuscular function, so when levels are high,the heart, nerves, and muscles are often affected.With mild elevations of potassium, you may not have any symptoms, but as levels increase, yoursymptomsmay include:
Signs and Symptoms of Hyperkalemia
There are many factors that can contribute toincreased potassium levels, but the most common is kidney problems likeacute kidney failureor chronic kidney disease. Other common potential causes include:
Normal vs. High Potassium Levels in the Blood
It’s important to make sure that you have true hyperkalemia.
Hyperkalemia isdiagnosedthrough blood tests that check potassium levels and through cardiac tests that show abnormal cardiac rhythm.
Between all of these tests, your healthcare provider will be able to diagnose you with hyperkalemia fairly quickly if you truly have it.
Sometimes your blood test may show that you have a high level of potassium when you actually don’t; this is known as pseudohyperkalemia. This can happen if the red cells in the blood sample rupture, releasing potassium into the sample.It can also happen if an extremely tight tourniquet is used for several minutes during the blood draw while looking for a vein, especially if you open and close your fist repeatedly to expand your veins.
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Pseudohyperkalemia can also occur when you have a very high white blood cell or platelet count.If a high potassium level is found when you have no obvious reason for hyperkalemia, and if you don’t have any symptoms or signs of hyperkalemia, the blood test needs to be repeated.
With pseudohyperkalemia, the serum potassium level is significantly higher than the plasma potassium level. (Serum is what is left after the blood clots, while plasma is the liquid that remains when clotting is prevented with an anticoagulant.) Because of this, some healthcare providers prefer blood tests done using plasma to make sure you don’t have pseudohyperkalemia.
How Hyperkalemia Is Diagnosed
Hyperkalemia
Diet
Eating ahealthy dietthat limits your potassium intake is important if you have kidney disease or other conditions that put you at high risk of developing hyperkalemia.This includes limiting or avoidingfoods high in potassium, such as many dairy products, vegetables, fruits, dry beans, and nuts.
Low-Potassium Diet
A Word From Verywell
Hyperkalemia is a potentially dangerous condition, but it can be successfully reversed. When high potassium levels occur, it’s important to have your healthcare provider quickly assess your immediate level of danger and work to get your blood potassium levels back to normal. It’s also critical to find the underlying cause of your hyperkalemia so it can be treated, if necessary, and so that steps can be taken to prevent it from happening again.
Symptoms of High Potassium (Hyperkalemia)
13 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.Simon LV, Farrell MW.Hyperkalemia. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470284/Belmar vega L, Galabia ER, Bada da silva J, et al.Epidemiology of hyperkalemia in chronic kidney disease. Nefrologia; 39(3):277-286.Shrimanker I, Bhattarai S.Electrolytes. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK541123/Weaver CM.Potassium and health. Adv Nutr; 4(3):368S-77S.Braun EJ.Regulation of renal and lower gastrointestinal function: role in fluid and electrolyte balance. Comp Biochem Physiol, Part A Mol Integr Physiol; 136(3):499-505.Udensi UK, Tchounwou PB.Potassium Homeostasis, Oxidative Stress, and Human Disease.Int J Clin Exp Physiol. 2017;4(3):111–122. doi:10.4103/ijcep.ijcep_43_17Lehnhardt A, Kemper MJ.Pathogenesis, diagnosis and management of hyperkalemia.Pediatr Nephrol. 2011;26(3):377–384. doi:10.1007/s00467-010-1699-3Kim S, Joo KW.Electrolyte and Acid-base disturbances associated with non-steroidal anti-inflammatory drugs.Electrolyte Blood Press. 2007;5(2):116–125. doi:10.5049/EBP.2007.5.2.116Howard SC, Jones DP, Pui CH.The tumor lysis syndrome[published correction appears in N Engl J Med. 2018 Sep 13;379(11):1094].N Engl J Med. 2011;364(19):1844–1854. doi:10.1056/NEJMra0904569Šálek T.Pseudohyperkalemia - Potassium released from cells due to clotting and centrifugation - a case report.Biochem Med (Zagreb). 2018;28(1):011002. doi:10.11613/BM.2018.011002Alhaj Moustafa M, Malkovska V, Elmahdy S, Catlett J.A Challenging Case of Pseudohyperkalemia in Chronic Lymphocytic Leukemia.J Investig Med High Impact Case Rep. 2017;5(4):2324709617746194. Published 2017 Dec 13. doi:10.1177/2324709617746194Mushiyakh Y, Dangaria H, Qavi S, Ali N, Pannone J, Tompkins D.Treatment and pathogenesis of acute hyperkalemia.J Community Hosp Intern Med Perspect. 2012;1(4):10.3402/jchimp.v1i4.7372. Published 2012 Jan 26. doi:10.3402/jchimp.v1i4.7372Cupisti A, Kovesdy CP, D’Alessandro C, Kalantar-Zadeh K.Dietary Approach to Recurrent or Chronic Hyperkalaemia in Patients with Decreased Kidney Function.Nutrients. 2018;10(3):261. Published 2018 Feb 25. doi:10.3390/nu10030261Additional ReadingMayo Clinic Staff.High Potassium (Hyperkalemia). Mayo Clinic.Mount DB.Treatment and Prevention of Hyperkalemia in Adults. UpToDate.Meng QH, Wagar EA.Pseudohyperkalemia: A New Twist on an Old Phenomenon.Critical Reviews in Clinical Laboratory Science. 2015;52(2):45-55. doi:10.3109/10408363.2014.966898.Wilson FP, Berns JS.Tumor Lysis Syndrome: New Challenges and Recent Advances.Advances in Chronic Kidney Disease. 2014;21(1):18-26. doi:10.1053/j.ackd.2013.07.001.
13 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.Simon LV, Farrell MW.Hyperkalemia. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470284/Belmar vega L, Galabia ER, Bada da silva J, et al.Epidemiology of hyperkalemia in chronic kidney disease. Nefrologia; 39(3):277-286.Shrimanker I, Bhattarai S.Electrolytes. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK541123/Weaver CM.Potassium and health. Adv Nutr; 4(3):368S-77S.Braun EJ.Regulation of renal and lower gastrointestinal function: role in fluid and electrolyte balance. Comp Biochem Physiol, Part A Mol Integr Physiol; 136(3):499-505.Udensi UK, Tchounwou PB.Potassium Homeostasis, Oxidative Stress, and Human Disease.Int J Clin Exp Physiol. 2017;4(3):111–122. doi:10.4103/ijcep.ijcep_43_17Lehnhardt A, Kemper MJ.Pathogenesis, diagnosis and management of hyperkalemia.Pediatr Nephrol. 2011;26(3):377–384. doi:10.1007/s00467-010-1699-3Kim S, Joo KW.Electrolyte and Acid-base disturbances associated with non-steroidal anti-inflammatory drugs.Electrolyte Blood Press. 2007;5(2):116–125. doi:10.5049/EBP.2007.5.2.116Howard SC, Jones DP, Pui CH.The tumor lysis syndrome[published correction appears in N Engl J Med. 2018 Sep 13;379(11):1094].N Engl J Med. 2011;364(19):1844–1854. doi:10.1056/NEJMra0904569Šálek T.Pseudohyperkalemia - Potassium released from cells due to clotting and centrifugation - a case report.Biochem Med (Zagreb). 2018;28(1):011002. doi:10.11613/BM.2018.011002Alhaj Moustafa M, Malkovska V, Elmahdy S, Catlett J.A Challenging Case of Pseudohyperkalemia in Chronic Lymphocytic Leukemia.J Investig Med High Impact Case Rep. 2017;5(4):2324709617746194. Published 2017 Dec 13. doi:10.1177/2324709617746194Mushiyakh Y, Dangaria H, Qavi S, Ali N, Pannone J, Tompkins D.Treatment and pathogenesis of acute hyperkalemia.J Community Hosp Intern Med Perspect. 2012;1(4):10.3402/jchimp.v1i4.7372. Published 2012 Jan 26. doi:10.3402/jchimp.v1i4.7372Cupisti A, Kovesdy CP, D’Alessandro C, Kalantar-Zadeh K.Dietary Approach to Recurrent or Chronic Hyperkalaemia in Patients with Decreased Kidney Function.Nutrients. 2018;10(3):261. Published 2018 Feb 25. doi:10.3390/nu10030261Additional ReadingMayo Clinic Staff.High Potassium (Hyperkalemia). Mayo Clinic.Mount DB.Treatment and Prevention of Hyperkalemia in Adults. UpToDate.Meng QH, Wagar EA.Pseudohyperkalemia: A New Twist on an Old Phenomenon.Critical Reviews in Clinical Laboratory Science. 2015;52(2):45-55. doi:10.3109/10408363.2014.966898.Wilson FP, Berns JS.Tumor Lysis Syndrome: New Challenges and Recent Advances.Advances in Chronic Kidney Disease. 2014;21(1):18-26. doi:10.1053/j.ackd.2013.07.001.
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.
Simon LV, Farrell MW.Hyperkalemia. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470284/Belmar vega L, Galabia ER, Bada da silva J, et al.Epidemiology of hyperkalemia in chronic kidney disease. Nefrologia; 39(3):277-286.Shrimanker I, Bhattarai S.Electrolytes. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK541123/Weaver CM.Potassium and health. Adv Nutr; 4(3):368S-77S.Braun EJ.Regulation of renal and lower gastrointestinal function: role in fluid and electrolyte balance. Comp Biochem Physiol, Part A Mol Integr Physiol; 136(3):499-505.Udensi UK, Tchounwou PB.Potassium Homeostasis, Oxidative Stress, and Human Disease.Int J Clin Exp Physiol. 2017;4(3):111–122. doi:10.4103/ijcep.ijcep_43_17Lehnhardt A, Kemper MJ.Pathogenesis, diagnosis and management of hyperkalemia.Pediatr Nephrol. 2011;26(3):377–384. doi:10.1007/s00467-010-1699-3Kim S, Joo KW.Electrolyte and Acid-base disturbances associated with non-steroidal anti-inflammatory drugs.Electrolyte Blood Press. 2007;5(2):116–125. doi:10.5049/EBP.2007.5.2.116Howard SC, Jones DP, Pui CH.The tumor lysis syndrome[published correction appears in N Engl J Med. 2018 Sep 13;379(11):1094].N Engl J Med. 2011;364(19):1844–1854. doi:10.1056/NEJMra0904569Šálek T.Pseudohyperkalemia - Potassium released from cells due to clotting and centrifugation - a case report.Biochem Med (Zagreb). 2018;28(1):011002. doi:10.11613/BM.2018.011002Alhaj Moustafa M, Malkovska V, Elmahdy S, Catlett J.A Challenging Case of Pseudohyperkalemia in Chronic Lymphocytic Leukemia.J Investig Med High Impact Case Rep. 2017;5(4):2324709617746194. Published 2017 Dec 13. doi:10.1177/2324709617746194Mushiyakh Y, Dangaria H, Qavi S, Ali N, Pannone J, Tompkins D.Treatment and pathogenesis of acute hyperkalemia.J Community Hosp Intern Med Perspect. 2012;1(4):10.3402/jchimp.v1i4.7372. Published 2012 Jan 26. doi:10.3402/jchimp.v1i4.7372Cupisti A, Kovesdy CP, D’Alessandro C, Kalantar-Zadeh K.Dietary Approach to Recurrent or Chronic Hyperkalaemia in Patients with Decreased Kidney Function.Nutrients. 2018;10(3):261. Published 2018 Feb 25. doi:10.3390/nu10030261
Simon LV, Farrell MW.Hyperkalemia. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470284/
Belmar vega L, Galabia ER, Bada da silva J, et al.Epidemiology of hyperkalemia in chronic kidney disease. Nefrologia; 39(3):277-286.
Shrimanker I, Bhattarai S.Electrolytes. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK541123/
Weaver CM.Potassium and health. Adv Nutr; 4(3):368S-77S.
Braun EJ.Regulation of renal and lower gastrointestinal function: role in fluid and electrolyte balance. Comp Biochem Physiol, Part A Mol Integr Physiol; 136(3):499-505.
Udensi UK, Tchounwou PB.Potassium Homeostasis, Oxidative Stress, and Human Disease.Int J Clin Exp Physiol. 2017;4(3):111–122. doi:10.4103/ijcep.ijcep_43_17
Lehnhardt A, Kemper MJ.Pathogenesis, diagnosis and management of hyperkalemia.Pediatr Nephrol. 2011;26(3):377–384. doi:10.1007/s00467-010-1699-3
Kim S, Joo KW.Electrolyte and Acid-base disturbances associated with non-steroidal anti-inflammatory drugs.Electrolyte Blood Press. 2007;5(2):116–125. doi:10.5049/EBP.2007.5.2.116
Howard SC, Jones DP, Pui CH.The tumor lysis syndrome[published correction appears in N Engl J Med. 2018 Sep 13;379(11):1094].N Engl J Med. 2011;364(19):1844–1854. doi:10.1056/NEJMra0904569
Šálek T.Pseudohyperkalemia - Potassium released from cells due to clotting and centrifugation - a case report.Biochem Med (Zagreb). 2018;28(1):011002. doi:10.11613/BM.2018.011002
Alhaj Moustafa M, Malkovska V, Elmahdy S, Catlett J.A Challenging Case of Pseudohyperkalemia in Chronic Lymphocytic Leukemia.J Investig Med High Impact Case Rep. 2017;5(4):2324709617746194. Published 2017 Dec 13. doi:10.1177/2324709617746194
Mushiyakh Y, Dangaria H, Qavi S, Ali N, Pannone J, Tompkins D.Treatment and pathogenesis of acute hyperkalemia.J Community Hosp Intern Med Perspect. 2012;1(4):10.3402/jchimp.v1i4.7372. Published 2012 Jan 26. doi:10.3402/jchimp.v1i4.7372
Cupisti A, Kovesdy CP, D’Alessandro C, Kalantar-Zadeh K.Dietary Approach to Recurrent or Chronic Hyperkalaemia in Patients with Decreased Kidney Function.Nutrients. 2018;10(3):261. Published 2018 Feb 25. doi:10.3390/nu10030261
Mayo Clinic Staff.High Potassium (Hyperkalemia). Mayo Clinic.Mount DB.Treatment and Prevention of Hyperkalemia in Adults. UpToDate.Meng QH, Wagar EA.Pseudohyperkalemia: A New Twist on an Old Phenomenon.Critical Reviews in Clinical Laboratory Science. 2015;52(2):45-55. doi:10.3109/10408363.2014.966898.Wilson FP, Berns JS.Tumor Lysis Syndrome: New Challenges and Recent Advances.Advances in Chronic Kidney Disease. 2014;21(1):18-26. doi:10.1053/j.ackd.2013.07.001.
Mayo Clinic Staff.High Potassium (Hyperkalemia). Mayo Clinic.
Mount DB.Treatment and Prevention of Hyperkalemia in Adults. UpToDate.
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