Hyperkalemia is a condition when the level of potassium in the blood is too high. This condition most often occurs as a result of kidney failure, either acute or chronic. Symptoms that arise as a result of hyperkalemia can vary, ranging from muscle weakness, tingling, to heart rhythm disturbances.

Potassium is a mineral that plays an important role in the body, especially in maintaining muscle, nerve and heart function. Normally, the body maintains potassium levels by excreting excess potassium through urine.

The normal level of potassium in the blood is 3,5ꟷ5,0 mEq/L. A person is said to be suffering from hyperkalemia when the level of potassium in his blood is more than 5.0 mEq/L.

Based on high levels of potassium in the blood, hyperkalemia is divided into several types, namely:

  • Mild hyperkalemia, namely potassium levels in the blood of 5.1ꟷ6.0 mEq/L
  • Moderate hyperkalemia, namely the level of potassium in the blood of 6.1ꟷ7.0 mEq/L
  • Severe hyperkalemia, namely the level of potassium in the blood above 7.0 mEq/L

Causes and Risk Factors for Hyperkalemia

Hyperkalemia can be caused by various things, ranging from health problems to drug side effects. The following are some of the factors that can cause an increase in potassium levels in the blood:

1. Impaired kidney function

Any disease or condition that can interfere with kidney function can cause hyperkalemia. The reason is, one of the functions of the kidneys is to remove excess potassium from the body. So, when kidney function is disturbed, potassium levels in the body will increase.

Some diseases or conditions that can cause impaired kidney function are:

  • Acute kidney failure
  • Chronic kidney failure
  • Lupus of the kidneys ( lupus nephritis)
  • Urinary tract disease, such as urinary tract stones
  • Rejection reactions from organ transplants

2. Diseases of the adrenal glands

The adrenal glands are small glands on top of the kidneys that produce the hormones cortisol and aldosterone. The hormone aldosterone helps regulate the amount of sodium and fluid in the kidneys, and excretes potassium through the urine. If the level of the hormone aldosterone decreases, the amount of potassium in the blood will increase.

Therefore, adrenal gland diseases that cause a decrease in aldosterone hormone levels, such as Addison's disease , can cause potassium levels in the blood to increase.

3. Release of potassium into the bloodstream

Normally, more potassium is inside the body's cells than outside the body's cells. Therefore, any condition that increases the release of potassium out of the body's cells can cause hyperkalemia. These conditions include:

  • Type 1 diabetes
  • Hemolytic anemia
  • Diabetic ketoacidosis
  • Rhabdomyolysis
  • Complications of cancer treatment (tumor lysis syndrome)
  • Serious injury
  • Extensive burns
  • Operational action
  • Blood transfusion

4. Use of drugs

A number of medications can decrease the body's ability to excrete potassium through the urine. As a result, the level of potassium in the blood increases. These drugs include:

  • Potassium-sparing diuretics , such as spironolactone
  • Non-steroidal anti-inflammatory drugs ( NSAIDs ), such as ibuprofen and aspirin
  • ACE inhibitors, seperti captopril
  • Angiotensin receptor blocker drugs (ARBs), such as candesartan
  • Beta blockers, such as propranolol
  • Heparin
  • Potassium supplement

Symptoms of Hyperkalemia

Symptoms of hyperkalemia depend on the high level of potassium in the blood. In some cases, people with hyperkalemia do not experience any symptoms. However, if the level of potassium in the blood rises high enough, complaints may appear in the form of:

  • Weakness or muscle weakness
  • Nausea and vomiting
  • Tingling and numbness
  • Chest pain
  • Respiratory disorders
  • Heart pounding
  • Paralysis
  • Cardiac arrest that can cause death

When to see a doctor

Check with your doctor if you experience the above symptoms, especially if you suffer from an illness or take drugs that can increase your risk of hyperkalemia.

Immediately seek medical attention to the emergency room if you experience the following symptoms:

  • Hard to breathe
  • Severe muscle weakness
  • Diarrhea and abdominal pain
  • The pulse is weak

Apart from that, you also need to see a doctor if you have been diagnosed with hyperkalemia and have symptoms, especially if the symptoms are quite severe. You will be hospitalized until the potassium level in your blood returns to normal.

Diagnosis of Hyperkalemia

The doctor will begin the examination by asking about symptoms, medical history, diet, and medications that the patient is currently taking. After that, the doctor performs a physical examination, including checking the patient's heartbeat.

To confirm the diagnosis, the doctor will carry out supporting examinations, such as:

  • Blood and urine tests, to check the levels of potassium, urea, creatinine, blood sugar, and calcium in the blood or urine samples
  • Electrocardiography (EKG), to detect heart rhythm disturbances that may occur in hyperkalemia patients

Treatment of Hyperkalemia

Treatment of hyperkalemia depends on the cause, severity, and overall condition of the patient. Patients with mild hyperkalemia usually do not need to be hospitalized, especially if the EKG results are normal and there are no comorbidities such as kidney failure.

Conversely, if the ECG shows abnormal results and the symptoms are severe enough, the patient needs to be hospitalized so that his heart rhythm is monitored.

Some methods of treating hyperkalemia are:

  • Insulin and glucose infusion, to lower potassium levels by pulling potassium back into the body's cells
  • Calcium infusion, to protect the heart and muscles
  • Infusion of sodium bicarbonate, to overcome too high levels of acid in the body ( acidosis ) and draw potassium back into the body's cells
  • Hemodialysis or dialysis , to filter and remove excess potassium from the blood
  • Medicines, such as diuretics , calcium gluconate, potassium binding drugs in the stomach (patiromer), and albuterol, to lower potassium levels in the blood or relieve symptoms that appear

To lower potassium levels in the blood, there are several independent therapies that patients with mild hyperkalemia can do to speed up the healing process. These therapies are:

  • Strictly limit high-potassium foods
  • Drink lots of water to prevent dehydration
  • Stop taking drugs that increase the risk of hyperkalemia

Hyperkalemia Complications

Hyperkalemia can cause arrhythmias or heart rhythm disturbances. This condition can trigger ventricular fibrillation which causes the lower heart to beat fast but does not pump blood.

Hyperkalemia that is not treated immediately can also cause cardiac arrest, paralysis, and even death.

Hyperkalemia prevention

The best way to prevent hyperkalemia is to reduce the risk of the condition occurring. Some things that can be done are:

  • Living a healthy lifestyle to prevent diabetes which can lead to kidney failure ( diabetic nephropathy )
  • Drink enough water, at least 8 glasses per day or as needed, to maintain kidney health
  • Do not carelessly take drugs or supplements without first consulting a doctor

In addition, for people with diseases that are at risk of developing hyperkalemia, there are several other efforts that can be made, namely:

  • Carry out routine control and treatment to the doctor if you have kidney disease, diabetes, or heart disease
  • Undergoing a low potassium diet, namely by limiting consumption of foods high in potassium, such as avocados, bananas, tomatoes, kidney beans, and sweet potatoes
  • Do not take herbal supplements or other supplements without first consulting a doctor
Back to blog