ľ¹ÏÖ±²¥

What is hyperkalemia?

Hyperkalemia is when the level of potassium in your blood is too high. You may not feel symptoms if it’s a mild case. It may also be easy to treat. If it gets worse and isn’t treated, it can lead to fatal heart  arrhythmias (abnormal heart rhythms). 

You may be at risk for hyperkalemia because of:

• Chronic kidney disease
• Diabetes
• Heart failure
• Medications that change potassium balance, such as some blood pressure medications

Sometimes, the cause is not clear or there are a few causes. 

How does hyperkalemia affect the body?

Potassium is important for normal cell function, including heart muscle cells. You get potassium from the foods you eat. 

The right level of potassium is key. Your kidneys help keep the right amount of potassium in your body. Hyperkalemia can happen if:

• You take in more potassium than your kidneys can remove 
• Your kidneys aren’t working well 

Potassium and sodium are important for the heart’s electrical signals. Too much potassium can affect these signals and cause heart rhythm problems.

How is it diagnosed?

It can be hard to diagnose hyperkalemia. It often has no symptoms. When there are symptoms, they might include muscle weakness or even muscle paralysis. A severe case can cause abnormal heart rhythms and can cause your heart to stop.

A health care professional may diagnose hyperkalemia based on: 

• A history of kidney failure
• Use of certain medications that cause high potassium
• Lab tests to check potassium levels
• A heart test called an EKG (electrocardiogram)

A normal potassium level is between 3.5 and 5.0 millimoles per liter (mmol/L). Hyperkalemia is when your level is above 5.5. Patients with hyperkalemia might have a normal EKG or an EKG with slight changes. 

Can you prevent hyperkalemia?

Changes in your eating patterns can help prevent and treat high potassium. Talk to your health care professional about foods to limit or avoid, including:

• Asparagus
• Avocados
• Potatoes
• Tomatoes or tomato sauce
• Winter squash
• Pumpkin
• Cooked spinach
• Oranges and orange juice
• Nectarines
• Kiwifruit
• Bananas
• Cantaloupe
• Honeydew
• Prunes and raisins 
• Other dried fruit

If you are on a low-salt eating plan, avoid using salt substitutes. 

How is hyperkalemia treated? 

You need emergency treatment if:

• Your potassium level is very high 
• Your heart shows signs of trouble on an EKG 

Treatment might include:

• Getting calcium through an IV to help your muscles and heart
• Getting glucose and insulin through an IV to lower your potassium levels.  

Emergency treatment might also include:

• Kidney dialysis if your kidneys aren’t working well 
• Medication to stop potassium from being absorbed
• Sodium bicarbonate if your body is to acidic 
• Water pills (diuretics)

A health care professional could also suggest that you: 

• Stop or reduce potassium supplements 
• Stop or change the doses of some medications for heart disease and high blood pressure 

Follow your health professional’s instructions about what medications to take.

For people with heart failure

Some heart failure medications are associated with high potassium, such as: 

• ARBs (angiotensin receptor blockers) 
• ACE inhibitors (angiotensin-converting enzyme inhibitors) 

For heart failure patients with recurrent hyperkalemia, potassium binders may be given to help lower potassium levels. These may include:

• Patiromer (Veltassa)  
• Sodium zirconium cyclosilicate (Lokelma)