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Hyperkalemia resulting from electrolyte disturbance (also called hyperpotasemia) is an excess of potassium (K +) in the blood serum that exceeds 5,5 mmol / L. Its consequences may be muscle paralysis, arrhythmia or – in extreme cases – cardiac arrest.
| Name of the disease / condition | Hyperkalemia |
| Introduction (e.g. description of the disease) | Hyperkalaemia (also called hyperpotasemia) resulting from electrolyte disturbance is an excess of potassium (K +) in the blood serum that exceeds 5,5 mmol / L. |
| The name of the disease – symptoms | non-specific symptoms, such as muscle aches and tingling sensation, balance disorders, dizziness, problems with coordination, irregular heart beat. The latter may result in bradycardia or additional contractions. In this situation, there is a risk of ventricular fibrillation and, consequently, cardiac arrest. |
| Name of the disease – causes | Excessive amount of potassium in the diet with the simultaneous insufficient excretion of this element by the kidneys, impaired transport of potassium inside the body, disturbances in the water and electrolyte balance, tissue hypoxia, sudden release of potassium from damaged cells, crush syndrome, prolonged hypoglycaemia, metabolic acidosis, dehydration, strychnine poisoning , treatment with cytostatics, insufficient adrenal cortex (Addison’s disease) or hypoaldosteronism. |
| The name of the disease – treatment | Depending on individual predispositions – elimination of the causes of hyperkalemia, e.g. discontinuation of inducing drugs, administration of agents that reduce serum potassium levels, hemodialysis, administration of laxatives or enemas. |
| Name of the disease – prognosis | The disease can be life or health threatening. |
| Name of the disease – prophylaxis | Remember to reduce the amount of potassium supplied to the body in the diet. |
| Other important (if any) | x |
Hyperkalemia – causes
In the body, potassium is responsible for muscle contractility, conduction of impulses between nerve cells and the maintenance of proper blood pressure. One of the main sources of hyperkalemia is chronic kidney disease. It can be caused by an excessive amount of potassium in the diet with a simultaneous insufficient excretion of this element by the kidneys, as well as impaired potassium transport inside the body, disturbances in the water and electrolyte balance, tissue hypoxia, sudden release of potassium from damaged cells, crush syndrome, prolonged hypoglycaemia or metabolic acidosis, haemolysis.
Hyperkalemia can also be caused by dehydration, strychnine poisoning, treatment with cytostatics, adrenal insufficiency (Addison’s disease) or hypoaldosteronism.
The most common form of hyperkalemia is drug induced hyperkalemia, which is caused by the ingestion of drugs commonly used in the treatment of hypertension that block the ENaC sodium channel in the renal tubules. Drug-induced hyperkalemia may also be the result of a stop in the production of renin caused by the use of ACE-inhibitors, angiotensin receptor blockers or non-steroidal anti-inflammatory drugs.
Hyperkalemia – symptoms
There are three types of hyperkalemia:
- mild (5,5 mmol / l),
- moderate (from 6,0-6,4 mmol / l),
- severe (greater than 6,5 mmol / l).
Hyperkalemia is characterized by non-specific symptoms, such as: muscle aches and tingling sensation, balance disorder, dizziness, problems with coordination, irregular heart beat. The latter may result in bradycardia or additional contractions. In severe hyperkalaemia, there is a risk of developing ventricular fibrillation and, consequently, cardiac arrest.
Hyperkalemia – treatment
Each case of hyperkalaemia should be considered on an individual basis. There is no single method of treatment. Nevertheless, the most common treatment of mild hyperkalemia is to remove its causes, e.g. discontinuation of its inducing drugs, as well as administering agents that reduce serum potassium levels, including: calcium, glucose with insulin (administered as intravenous infusions), bicarbonates, beta-mimetics, ion exchange resins. You should also remember to reduce the amount of potassium supplied to the body in the diet.
If these treatments for hyperkalaemia are not successful, and hyperkalaemia persists above 6,5 mmol / L, hemodialysis should be performed. In some cases, medication for purging or giving an enema is also effective. If there is acidosis (often associated with kidney diseases), bicarbonates can be used, provided that pulmonary edema, hypokalemia (potassium deficiency) or hypernatremia (excess sodium) has not been previously diagnosed.