An Overview of Hyperkalemia

Hipercalemiaes el término para niveles altos de potasio en la sangre. Un nivel normal de potasio para adultos se considera de 3.6 a 5.2 mEq / L.

If your level gets above 6 mEq/L, you will need treatment right away because elevated levels can become dangerous if they get too high. Hyperkalemia is often caused by kidney disease, but it can be caused by other illnesses and factors, such as heart disease, diabetes, cancer, and certain medications.

Normal vs. high potassium levels in blood.

Table of Contents

Understanding Electrolytes

To better understand why potassium levels are important and what may cause them to increase or decrease, it’s helpful to know how electrolytes function in the body. Most people are familiar with electrolytes from Gatorade or Pedialyte commercials that stress rehydration after exercise (or vomiting and diarrhea in Pedialyte’s case) to balance our electrolyte levels. While the information contained in the commercials is factual, it doesn’t even begin to define the complexity of electrolytes and how critical they are to your body.

In the most simple terms, electrolytes are compound minerals that when dissolved in water separate into electrically charged ions. There are many types of electrolytes, but sodium, potassium, chloride, bicarbonate, calcium, sulfate, magnesium, and phosphate are considered the most important in the human body. Our bodies depend on potassium to regulate blood pressure, vascular tone, the normal function of insulin and various other hormones, gastrointestinal motility, acid-base balance, kidney function, and fluid and electrolyte balance.

Through hormones, specialized mechanisms, and transporters, the kidneys are responsible for monitoring the concentration and volume of electrolytes and water in the body. A basic example of how the kidneys regulate water and electrolytes is urination. When your body has excess fluid, your urine output is increased. When your body is dehydrated, your urine output is decreased. Any excess of electrolytes is expelled from your body through urine, sweat, and the digestive tract.

The kidneys have a strict margin of what is considered a low or high level of water or electrolytes in the body. When levels increase or decrease, the kidneys begin responding immediately. Experiencing thirst is a basic example of how our bodies respond to decreased water levels.

High potassium blood levels can disrupt the way certain organ systems function and can become fatal if left untreated. Because hyperkalemia can become quite dangerous, elevated potassium levels must be taken seriously, even if they are not yet producing any symptoms.

Symptoms

Potassium plays an important role in heart and neuromuscular function, so when levels are high, the heart, nerves, and muscles are often affected. With mild elevations of potassium, you may not have any symptoms, but as levels increase, your symptoms may include:

  • Muscle weakness or spasms
  • Fatigue
  • Shortness of breath and hyperventilation
  • Nausea and vomiting
  • Paralysis
  • Tingling sensations
  • Heart arrhythmias (irregular heart rhythms), which are one of the more serious complications
  • Confusion
  • Seizures, coma, and death when the levels are very high

Signs and Symptoms of Hyperkalemia

Causes

There are many factors that can contribute to increased potassium levels, but the most common is kidney problems like acute kidney failure or chronic kidney disease. Other common potential causes include:

  • Addison’s disease
  • Certain medications like angiotensin II receptor blockers, angiotensin-converting enzyme (ACE) inhibitors, nonsteroidal anti-inflammatory drugs (NSAIDs), and beta blockers
  • Ingesting too much potassium, such as in food, potassium supplements, or salt substitutes
  • Dehydration
  • Type 1 diabetes
  • Red blood cells being destroyed because of burns or other severe injuries
  • Tumor lysis syndrome
  • Blood transfusions

Causes and Risk Factors of Hyperkalemia

Diagnosis

It’s important to make sure that you have true hyperkalemia.

Hyperkalemia is diagnosed through blood tests that check kidney function and potassium levels, urine tests, and/or cardiac tests.

Between all of these tests, your doctor will be able to diagnose you with hyperkalemia fairly quickly if you truly have it.

Sometimes your blood test may show that you have a high level of potassium when you actually don’t; this is known as pseudohyperkalemia. This can happen if the red cells in the blood sample rupture, releasing potassium into the sample. It can also happen if an extremely tight tourniquet is used for several minutes during the blood draw while looking for a vein, especially if you open and close your fist repeatedly to expand your veins.

La pseudohipercalemia también puede ocurrir cuando tiene un recuento de plaquetas o glóbulos blancos muy alto. Si se encuentra un nivel alto de potasio cuando no tiene una razón obvia para la hiperpotasemia, y si no tiene ningún síntoma o signos de hipercalemia, debe repetirse el análisis de sangre.

Con la pseudohipercalemia, el nivel de potasio en suero es significativamente más alto que el nivel de potasio en plasma. Debido a esto, algunos médicos prefieren los análisis de sangre que se realizan con plasma para asegurarse de que no tenga pseudohipercalemia.Cómo se diagnostica la hipercalemia

Tratamiento

La mayoría de las veces, la hiperpotasemia es leve y puede tratarse simplemente restringiendo el potasio en su dieta y tratando la causa subyacente. Si es más grave, las opciones de tratamiento pueden incluir:

  • Diuréticos (pastillas de agua)
  • Intravenosa (IV) glucosa e insulina
  • Calcio intravenoso
  • Diálisis
  • Agentes eliminadores de potasio como el patirómero, que se une al potasio en el tracto digestivo a cambio de calcio

Cómo se trata la hipercalemia

Dieta

Comer una dieta saludable que limite su consumo de potasio es importante si tiene una enfermedad renal u otras afecciones que lo ponen en un alto riesgo de desarrollar hiperpotasemia. Esto incluye limitar o evitar los alimentos con alto contenido de potasio, como muchos productos lácteos, verduras, frutas, frijoles secos y nueces.