HYPERKALEMIA
Hyperkalemia is an elevated level of potassium in the bloodstream.
- Potassium is a very significant body mineral. It is one of the main blood minerals called ‘electrolytes’ –
- the others are sodium and chloride.
- It carries a tiny electrical potential and is critical to the function of the nerve and muscle cells, including those in the heart.
- It helps the body regulate the activity of the muscle as well as maintain normal heart electrical rhythm.
- It also regulates the water balance and acid-base balance in the blood.
- Potassium is found in a wide range of food such as fresh fruits and vegetables – tomatoes, sweet potatoes, oranges, broccoli, blackberries, apples, banana, avocados, peas, lima beans, and apricots.
- Whole grains, nuts, fish such as salmon, sardines, and cod are rich in potassium
- The normal blood potassium level is normally 3.6 to 5.0 millimoles per liter (mmol/L)
- The severity of hyperkalemia is divided into mild, moderate and severe.
- Potassium level between 5.5 – 5.9 mmol/L reflects mild hyperkalemia.
- Potassium level between 6.0 – 6.4 mmol/L reflects moderate hyperkalemia
- And levels above 6.5 mmol/L are severe hyperkalemia
- Circumstances that interfere with potassium balance can affect the electrical impulse necessary to sustain heartbeat, causing an abnormal heart rhythm or even sudden death.
CAUSES
The common cause is:
- Kidney dysfunction such as acute kidney failure and chronic kidney disease. This is the major cause of the condition. Extra potassium that the body does not need is removed from the blood by the kidney. When there is a dysfunction in the kidney, the kidney is unable to remove extra potassium in the right way and too much of it stays in the blood
- Medications such as beta blockers, ACE inhibitors. NSAIDs, angiotensin ii receptor blocker
- Dehydration
- Type 1 diabetes
- Disease of the adrenal gland such as Addison’s disease
- Rhabdomyolysis
- Internal bleeding
SYMPTOMS
- Feeling tired or weak
- Unusual/irregular heartbeats or palpitations
- Chest pain
- Trouble breathing
- Nausea
- Muscle pain
DIAGNOSIS AND TREATMENT
The diagnosis may involve taking your medical history and carrying out a blood test
The blood test measures the level of potassium in the blood. The blood test is like many other, a small needle is placed into a vein on your arm and your blood is drawn out into a tube and then sent to the lab to be tested.
An electrocardiogram will also be done to check for significant risk of abnormal heart rhythms.
TREATMENT
Treatment may depend upon the underlying cause, the severity, and the overall health status of the patient.
Mild hyperkalemia in a healthy individual may be treated without any hospitalization. If the condition is severe, an emergency treatment that includes hospitalization in the intensive care unit under continuous heart rhythm monitoring may be necessary.
The goal of treatment is to help the body get rid of excess potassium quickly and stabilize the heart.
Hemodialysis is the most rapid method of removing potassium from the body. This is the best treatment option for those with kidney failure. Hemodialysis uses a machine to remove waste from the blood including excess potassium when the kidneys cannot.
Prescription drugs may also be used to treat high potassium levels. Such as
- Diuretics, pills that increase kidney potassium excretion in urine. These may include loop diuretics (furosemide), thiazide diuretics (chlorthalidone)
- Sodium polystyrene sulfonate (Kayexalate)
You may be advised to stop or change meds that are contributing to your condition
A low potassium diet per day
Intravenous administration of insulin which is given with an appropriate amount of glucose.