What Is Hyperkalemia and How Can You Treat It?

When someone has hyperkalemia, levels of potassium in the blood are higher than normal. There are different treatments to reverse this problem.
What Is Hyperkalemia and How Can You Treat It?

Last update: 14 April, 2020

Hyperkalemia happens when the level of potassium in the blood changes. Usually, these levels increase. However, we can also call it hyperkalemia if levels are lower than normal too.

Hyperkalemia occurs when levels are above 5.5 mmol/L.

What is potassium? Why do we need it?

What is hyperkalemia?
We need potassium so that the electrolytes that affect blood pressure can function normally.

First of all, potassium is a chemical element, represented by the letter “K” in the periodic table. It’s a macro-mineral with important functions, both at the muscular level and for the nervous system.

It’s a macro-mineral and an electrolyte, just like calcium or chlorine. These electrolytes help balance the pressure and concentration of substances inside and outside the cells.

Therefore, the most important functions of potassium are:

  • The development of the skeleton
  • Balancing osmosis levels
  • Intervening in protein synthesis
  • It’s essential for nerve transmission
  • Helping muscle contraction

What causes hyperkalemia?

In general, it occurs when the kidneys remove less potassium than they should. Abnormal potassium movement outside cells can also be a common cause.

There are many reasons that contribute to why hyperkalemia develops. Among them are:

  • Increased potassium intake
  • Taking certain drugs that have a side effect of the kidney removing potassium
  • Acute kidney failure
  • Chronic kidney disease

Another cause is the presence of metabolic acidosis; patients suffering from diabetic ketoacidosis have this symptom.

On the other hand, pseudohyperkalmia is the artificial increase in potassium which can also trigger hyperkalemia. The first is caused by excessive use of an elastic band (tourniquet) or clenching your fist for too long when taking blood.

Furthermore, thrombocytosis can also cause pseudohyperkalemia, because potassium platelets are released during coagulation.


Most cases of hyperkalemia go unnoticed, meaning that there aren’t usually symptoms when potassium levels change. It can only be spotted through tests.

However, if symptoms do develop, this depends on the severity of hyperkalemia and how quickly it develops. Normally, initial symptoms are:

  • Muscular weakness
  • Tremors in the arms or legs
  • Tingling
  • Pins and needles in the fingers and toes

Furthermore, these symptoms are usually accompanied by insomnia, nausea, vomiting, and decreased cardiac activity.

In the most severe cases, the patient may suffer from cardiac arrhythmia. This is because the heart needs potassium to contract and for its functions to develop properly. Arrhythmia is a heartbeat disorder that affects the frequency, intensity, and regularity of nerve impulses.

How is it diagnosed?

A heart drawn with a pen.
The main complication of hyperkalemia is changes in the cardiac cycle.

This condition can be identified by measuring the serum concentration of electrolytes indicated as a control. This test is performed when the patient undergoes an electrocardiogram and the same results show variations.

Patients with kidney failure, advanced heart failure, urinary obstruction, or those treated with angiotensin inhibitors (ACE inhibitors) usually have abnormal electrocardiogram results. Therefore, in order for it to be correctly diagnosed, the following tests must be performed:

  • Kaliemia measurement
  • ECG
  • Medication review
  • Kidney function evaluation

How to treat it?

Above all, the reason why we treat it is to reduce potassium levels in the blood. In addition, we also treat the main cause of hyperkalemia such as interrupting administering hyperkalemic drugs.

In cases where increased potassium levels are moderate, administering certain medication, such as potassium exchange resins, should help decrease levels.  As a result, your doctor may also prescribe diuretics or dialysis.

So, if hyperkalemia values are above 6.5 mmol/L without changes in the electrocardiogram, salbutamol or sodium bicarbonate are two drugs that effectively improve the situation.

Finally, when potassium levels are also above 6.5 mmol /L, but with changes to the electrocardiogram, then the first thing to do is protect the heart. Administering calcium chloride can help to reduce kalemia (potassium levels in the blood).

Despite all the information previously provided, don’t hesitate to see your doctor if you have signs of this disease. A specialist will recommend the best treatment for you.

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