What are the causes and symptoms of high potassium levels? How is hyperkalemia diagnosed and treated? Get the facts about managing this potentially serious condition.

Understanding High Potassium Levels: Causes and Symptoms of Hyperkalemia

Potassium is an essential mineral that plays a crucial role in various bodily functions, including nerve and muscle communication, fluid balance, and heart function. However, when potassium levels in the blood become too high, a condition known as hyperkalemia can occur. In this comprehensive guide, we’ll explore the causes, symptoms, and management of high potassium levels.

Causes of Hyperkalemia: Identifying the Underlying Factors

Hyperkalemia can develop due to a variety of factors, including:

• Kidney disease: The kidneys are responsible for regulating potassium levels in the body. When the kidneys are not functioning properly, potassium can accumulate, leading to hyperkalemia.
• Medications: Certain medications, such as angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), and potassium-sparing diuretics, can cause an increase in potassium levels.
• Addison’s disease: This is a condition in which the adrenal glands do not produce enough of the hormone aldosterone, which helps regulate potassium levels.
• Tissue damage: Severe injuries, burns, or tissue breakdown can release potassium into the bloodstream, leading to hyperkalemia.
• Dietary factors: Consuming foods high in potassium, such as bananas, avocados, and certain types of nuts and legumes, can contribute to high potassium levels, especially in individuals with impaired kidney function.

Symptoms of Hyperkalemia: Recognizing the Warning Signs

Hyperkalemia may not always present with obvious symptoms, especially in the early stages. However, as potassium levels continue to rise, individuals may experience the following:

• Muscle weakness or paralysis
• Irregular heartbeat or palpitations
• Nausea and vomiting
• Abdominal pain
• Confusion or changes in mental status
• Numbness or tingling in the extremities

It’s important to note that high potassium levels can potentially lead to life-threatening cardiac arrhythmias, so it’s crucial to seek medical attention if you suspect hyperkalemia.

Diagnosing Hyperkalemia: Understanding the Testing Process

To diagnose hyperkalemia, healthcare providers will typically order a blood test to measure the level of potassium in the blood. This test, known as a serum potassium or K+ test, is a regular part of a basic or comprehensive metabolic panel. The test involves drawing a sample of blood, usually from a vein in the arm.

Once the blood sample is collected, it is analyzed in a laboratory. The normal range for serum potassium is typically between 3.7 and 5.2 milliequivalents per liter (mEq/L) or 3.70 to 5.20 millimoles per liter (mmol/L). Readings above this range indicate hyperkalemia.

Treating Hyperkalemia: Restoring Potassium Balance

The treatment for hyperkalemia will depend on the severity of the condition and the underlying cause. In mild cases, dietary modifications and medication adjustments may be sufficient to lower potassium levels. In more severe cases, healthcare providers may recommend:

• Intravenous (IV) administration of calcium, insulin, or glucose to temporarily lower potassium levels and stabilize the heart
• Medications that increase potassium excretion, such as diuretics or sodium polystyrene sulfonate
• Dialysis, in cases of end-stage kidney disease or life-threatening hyperkalemia

It’s important to work closely with your healthcare team to develop an appropriate treatment plan that addresses the underlying cause and effectively manages your potassium levels.

Preventing and Managing Hyperkalemia: Lifestyle and Dietary Considerations

In addition to medical treatment, there are steps you can take to help prevent and manage high potassium levels:

• Limit your intake of high-potassium foods, such as bananas, avocados, and certain types of nuts and legumes
• Maintain a balanced diet that includes a variety of fruits, vegetables, and whole grains
• Stay hydrated by drinking plenty of water
• Regularly monitor your potassium levels and discuss any changes with your healthcare provider
• Inform your healthcare team about any medications or supplements you are taking, as they may affect your potassium levels

By working closely with your healthcare team and making lifestyle and dietary adjustments, you can help manage your potassium levels and reduce the risk of complications associated with hyperkalemia.

Key Takeaways: Staying Informed About High Potassium Levels

In summary, high potassium levels, or hyperkalemia, can have serious health consequences if left untreated. By understanding the causes, symptoms, and management of this condition, you can take proactive steps to maintain optimal potassium balance and protect your overall health. Remember to work closely with your healthcare provider, monitor your potassium levels, and make informed decisions about your diet and lifestyle to ensure your well-being.

Potassium test Information | Mount Sinai

Hypokalemia test; Hyperkalemia test; K+

This test measures the amount of potassium in the fluid portion (serum) of the blood. Potassium (K+) helps nerves and muscles communicate. It also helps move nutrients into cells and waste products out of cells.

Potassium levels in the body are mainly controlled by the hormone aldosterone.

Blood is drawn from a vein (venipuncture), usually from the inside of the elbow or the back of the hand. A needle is inserted into the vein, and the blood is collected in an air-tight vial or a syringe. Preparation may vary depending on the specific test.

How the Test is Performed

A blood sample is needed. Most of the time, blood is drawn from a vein located on the inside of the elbow or the back of the hand.

How to Prepare for the Test

Many medicines can interfere with blood test results.

• Your health care provider will tell you if you need to stop taking any medicines before you have this test.
• DO NOT stop or change your medicines without talking to your provider first.

How the Test will Feel

You may feel slight pain or a sting when the needle is inserted. You may also feel some throbbing at the site after the blood is drawn.

Why the Test is Performed

This test is a regular part of a basic or comprehensive metabolic panel.

You may have this test to diagnose or monitor kidney disease. The most common cause of a high blood potassium level is kidney disease.

Potassium is important to heart function.

• Your provider may order this test if you have signs of high blood pressure or heart problems.
• Small changes in potassium levels can have a big effect on the activity of nerves and muscles, especially the heart.
• Low levels of potassium can lead to an irregular heartbeat or other electrical malfunction of the heart.
• High levels cause decreased heart muscle activity.
• Either situation can lead to life-threatening heart problems.

It may also be done if your provider suspects metabolic acidosis (for example, caused by uncontrolled diabetes) or alkalosis (for example, caused by excess vomiting).

Sometimes, the potassium test may be done in people who are having an attack of paralysis.

Normal Results

The normal range is 3.7 to 5.2 milliequivalents per liter (mEq/L) 3.70 to 5.20 millimoles per liter (millimol/L).

Normal value ranges may vary slightly among different laboratories. Talk to your provider about the meaning of your specific test results.

The examples above show the common measurements for results for these tests. Some laboratories use different measurements or may test different specimens.

What Abnormal Results Mean

High levels of potassium (hyperkalemia) may be due to:

• Addison disease (rare)
• Blood transfusion
• Certain medicines, including angiotensin converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), and the potassium-sparing diuretics spironolactone, beta adrenergic blockers, amiloride and triamterene
• Crushed tissue injury
• Hyperkalemic periodic paralysis
• Hypoaldosteronism (very rare)
• Kidney insufficiency or failure
• Metabolic or respiratory acidosis
• Red blood cell destruction
• Too much potassium in your diet

Low levels of potassium (hypokalemia) may be due to:

• Acute or chronic diarrhea
• Cushing syndrome (rare)
• Diuretics such as hydrochlorothiazide, furosemide, torsemide, and indapamide
• Hyperaldosteronism
• Hypokalemic periodic paralysis
• Not enough potassium in the diet
• Renal artery stenosis
• Renal tubular acidosis (rare)
• Vomiting

Risks

If it is hard to get the needle into the vein to take the blood sample, injury to the red blood cells may cause potassium to be released. This may cause a falsely high result.

Mount DB. Disorders of potassium balance. In: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. Brenner and Rector’s The Kidney. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 17.

Patney V, Whaley-Connell A. Hypokalemia and hyperkalemia. In: Lerma EV, Sparks MA, Topf JM, eds. Nephrology Secrets. 4th ed. Philadelphia, PA: Elsevier; 2019:chap 74.

Seifter JL. Potassium disorders. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 109.

Last reviewed on: 5/1/2021

Reviewed by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A. D.A.M. Editorial team.

Low potassium level Information | Mount Sinai

Potassium – low; Low blood potassium; Hypokalemia

Low blood potassium level is a condition in which the amount of potassium in the blood is lower than normal. The medical name of this condition is hypokalemia.

Blood is drawn from a vein (venipuncture), usually from the inside of the elbow or the back of the hand. A needle is inserted into the vein, and the blood is collected in an air-tight vial or a syringe. Preparation may vary depending on the specific test.

Causes

Potassium is an electrolyte (mineral). It is needed for cells to function properly. You get potassium through food. The kidneys remove excess potassium through the urinary system to keep a proper balance of the mineral in the body.

Common causes of low blood potassium include:

• Medicines, such as diuretics (water pills), certain antibiotics (amphotericin B, chloroquine at toxic levels)
• Diarrhea or vomiting
• Eating disorders (such as bulimia)
• Hyperaldosteronism
• Laxative overuse, which can cause diarrhea
• Chronic kidney disease
• Low magnesium level
• Sweating
• Genetic disorders, such as hypokalemic periodic paralysis, Bartter syndrome

Symptoms

A small drop in potassium level often does not cause symptoms, which may be mild, and may include:

• Constipation
• Feeling of skipped heart beats or palpitations
• Fatigue
• Muscle damage
• Muscle weakness or spasms
• Tingling or numbness

A large drop in potassium level may lead to abnormal heart rhythms, especially in people with heart disease. This can cause you to feel lightheaded or faint. A very low potassium level can even cause your heart to stop.

Exams and Tests

Your health care provider will order a blood test to check your potassium level. Normal range is 3.7 to 5.2 mEq/L (3.7 to 5.2 mmol/L).

Other blood tests may be ordered to check levels of:

• Glucose, magnesium, calcium, sodium, phosphorous
• Thyroid hormone
• Aldosterone

An electrocardiogram (ECG) to check the heart may also be done.

Treatment

If your condition is mild, your provider will likely prescribe oral potassium pills. If your condition is severe, you may need to get potassium through a vein (IV).

If you need diuretics, your provider may:

• Switch you to a form that keeps potassium in the body. This type of diuretic is called potassium-sparing.
• Prescribe extra potassium for you to take every day.

Eating foods rich in potassium can help treat and prevent low level of potassium. These foods include:

• Avocados
• Baked potato
• Bananas
• Bran
• Carrots
• Cooked lean beef
• Milk
• Oranges
• Peanut butter
• Peas and beans
• Salmon
• Seaweed
• Spinach
• Tomatoes
• Wheat germ

Outlook (Prognosis)

Taking potassium supplements can usually correct the problem. In severe cases, without proper treatment, a severe drop in potassium level can lead to serious heart rhythm problems that can be fatal.

Possible Complications

In severe cases, life-threatening paralysis may develop, such as with hypokalemic periodic paralysis.

When to Contact a Medical Professional

Call your provider right away if you have been vomiting or have had excessive diarrhea, or if you are taking diuretics and have symptoms of hypokalemia.

Mount DB. Disorders of potassium balance. In: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. Brenner and Rector’s The Kidney. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 17.

Seifter JL. Potassium disorders. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 109.

Last reviewed on: 5/1/2021

Reviewed by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Brief description of the blood test for potassium with a breakdown of the results and the reason for the increased and decreased values ​​of the level of potassium in the human body

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A blood test for potassium is a comprehensive examination method that determines the acid-base balance, evaluates the effectiveness of treatment, and also identifies many diseases

Preparation for the study:

• It is forbidden to smoke immediately before taking blood
• Avoid fatty, fried, spicy foods and alcohol from the diet the day before the examination.
• Do not take drugs, undergo FG or X-ray before the examination

Biomaterial type: venous blood

Synonyms (rus): Serum electrolytes

9002 1 Synonyms (eng): Electrolyte panel

Methods studies: inoselective electrodes

Units: mmol/l

Deadlines: 1 day

Why do you need a blood test for potassium?

Potassium is one of the body’s main electrolytes , which have the ability to conduct electrical charges, in addition, they maintain acidity and water balance in cells. Monitoring the level of potassium in the body is of great importance, as it allows you to identify even minor changes in this mineral compound, in which heart rhythm disturbances or other pathologies occur. Potassium enters the human body with food and then excreted by the kidneys.

A blood test for potassium is ordered by the attending physician or other specialist in the following conditions:

• cardiac arrhythmia;
• edema;
• general weakness;
• nausea;
• loss of consciousness.

With the help of the study of blood serum for electrolytes, diseases of the heart, kidneys, liver and many others are detected. A blood test is taken in the morning on an empty stomach from a vein using a syringe and tourniquet, after which it is examined by the method of ion-selective electrodes.

Explanation of the result of the analysis

Normally, the level of potassium in humans is from 3.5 to 5. 1 mmol per liter. A decrease in the concentration of potassium below 3.05 mmol per liter can occur with impaired kidney function (called a decrease in potassium “hypokalemia”). In this case, there is difficulty in breathing, vomiting and nausea, muscle weakness, excretion of feces and urine involuntarily.

A sharp increase in potassium above 7.15 mmol per liter is observed with a strong loss of fluid (this condition is called “hyperkalemia”). In this case, a slowing of the pulse, a drop in pressure, or a violation of sensitivity may appear. Also, deviations from the norm can be with diabetes mellitus, muscle disease, disruption of the cardiovascular system. An abnormal amount of potassium in the blood can be in the presence of toxic substances in the body, for example: oxalates, glycolates or aspirin.

The result of the study may be affected by the use of drugs such as estrogens, acetazolamide, phenylbutazone. Against the background of their intake, potassium may increase, and the result of the examination will not be accurate. The concentration of potassium may decrease while taking bicarbonates, theophylline, furosemide and metazalon.

Serum Potassium

Potassium is a mineral element that is an important part of most cells in the human body. It is the main intracellular ion. Together with sodium, it helps to maintain the necessary acid-base balance and ensures the normal functioning of nerves and muscles.

Russian synonyms

K, potassium ions, potassium in the blood.

English synonyms

Potassium, K, Serum.

Test method

Ion-selective electrodes.

Units

mmol/l (millimoles per litre).

What biomaterial can be used for research?

Venous blood.

How to properly prepare for the examination?

• Do not eat for 12 hours before the test.
• No smoking for 30 minutes prior to examination.

General information about the study

Potassium is a cation that interacts with other electrolytes: sodium, chlorine, bicarbonate; together they regulate the exchange of water in the body, muscle contractions, conduct nerve impulses and maintain acid-base balance. Potassium is excreted by the kidneys under the control of aldosterone produced by the adrenal glands in response to the production of angiotensin II and hyperkalemia.

The electrolyte is found mainly in the cells, only a small part of it is in the extracellular fluid and in the liquid part of the blood (plasma), this proportion is 2% of its total content in the body. The plasma potassium concentration is very low, so any, even small, changes will have pronounced consequences. With a significant increase or decrease in its level, a person’s health is in danger: from the development of shock to the formation of respiratory failure or cardiac arrhythmias. Deviations of this indicator from the norm can disrupt the transmission of impulses in muscle tissue and between neurons, for example, the heart muscle may lose the ability to contract.

What is research used for?

• To detect an increase or decrease in potassium levels – hyper- or hypokalemia – in a routine blood chemistry test.
• To control the level of potassium after the appointment of drugs that can affect it, such as diuretics, the frequent use of which is fraught with hypokalemia.
• To assess the patient’s condition in certain chronic diseases that lead to shifts in the concentration of potassium in the blood, for example, in chronic renal failure.

When is the examination scheduled?

• If you suspect any serious disease associated with a violation of the content of potassium.
• In conjunction with other electrolyte tests for a comprehensive assessment of electrolyte balance, especially when prescribing diuretics, heart medications or pressure problems.
• With arterial hypertension, chronic kidney disease.
• During dialysis sessions, diuretic therapy, any intravenous therapy.
• For symptoms of hyperkalemia: excitability, diarrhea, convulsions, oliguria, cardiac arrhythmia with sharp T-waves and progressive gastric fibrillation.
• For symptoms of hypokalemia: malaise, thirst, polyuria, anorexia, weak filling pulse, low blood pressure, vomiting, decreased reflexes, ECG changes with reduced T waves.

What do the results mean?

Reference values: 3.5 – 5.1 mmol/l.

Increased potassium levels – hyperkalemia – may indicate:

• acute or chronic renal failure (impaired concentration and excretory function of the kidneys),
• Addison’s disease (insufficient production of mineralocorticoids responsible for the hormonal regulation of potassium levels),
• hypoaldosteronism (aldosterone is responsible for removing potassium from the body),
• extensive tissue damage (massive release of potassium from the cell),
• infectious diseases,
• diabetes,
• dehydration (blood thickening occurs),
• a large intake of potassium from food, such as fruits and vegetables (bananas, grapefruits, oranges, tomatoes, melons, potatoes) or juices,
• deficiency of mineralcorticoids (ACTH, cortisone and hydrocortisone),
• hyporenin hypoaldosteronism.

A decrease in the concentration of potassium occurs in such pathological conditions as:

• problems with the gastrointestinal tract (vomiting, diarrhea, overdose of laxatives, fistulas, malabsorption syndrome), leading to loss of fluid rich in electrolytes from the body,
• diabetic ketoacidosis,
• primary and secondary hyperaldosteronism,
• Bartter syndrome,
• osmotic/post-obstructive diuresis,
• Cushing’s syndrome (increased production of glucocorticoids that inhibit potassium reabsorption in the kidneys),
• lack of intake of potassium from food (rare).

Hypokalemia can lead to serious cardiac disorders: ventricular extrasystoles, paroxysmal atrial tachycardia, ventricular tachycardia.

What can influence the result?

• Some drugs increase potassium levels: non-steroidal anti-inflammatory drugs, beta-blockers (propranolol, atenolol), angiotensin-converting enzyme inhibitors (captopril, enalapril, lisinopril), potassium-sparing diuretics (amiloride, triamterene, spironolactone), heparin, histamine, mannitol, lithium.