Hyperkalemia

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Circulatory system

High potassium; Potassium - high

Cardiac arrest (absent heartbeat) may occur at any time during the treatment of hyperkalemia. Hospitalization and close monitoring are required.

ACUTE TREATMENT

Emergency treatment is indicated if the potassium is very high, or if severe symptoms are present, including changes in the ECG.

The goal of acute treatment is to protect the body from the effects of hyperkalemia. Acute treatment may include:

• Cation-exchange resin medications, such as sodium polystyrene sulfonate (Kayexalate) -- to attach to potassium and cause it to be removed from the gastrointestinal tract
• Dialysis -- to reduce total body potassium levels, especially if kidney function is compromised
• Diuretic medications (water pills) -- to decrease total body potassium
• Intravenous calcium -- to temporarily treat muscle and heart effects of hyperkalemia
• Intravenous glucose and insulin -- to reverse severe symptoms long enough to correct the cause of the hyperkalemia
• Sodium bicarbonate -- to reverse hyperkalemia caused by acidosis

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LONG-TERM TREATMENT

Long-term treatment includes treating the cause of the problem and disorders associated with hyperkalemia.

Treatment of chronic renal failure may include:

• Limiting potassium in the diet, including reducing or stopping potassium supplements
• Taking "loop diuretics" to reduce potassium and fluid levels in people with chronic renal failure

People with kidney failure or a history of hyperkalemia should not use a salt substitute as part of a low-salt diet.

The outcome with this condition varies. In some people, the disorder causes deadly complications, while others tolerate it well.

• Arrhythmias
• Cardiac arrest
• Changes in nerve and muscle (neuromuscular) control

Go to the emergency room or call the local emergency number (such as 911) if you have symptoms of hyperkalemia. Emergency symptoms include:

• Absent or weak heartbeat
• Changes in breathing pattern
• Loss of consciousness
• Nausea
• Weakness

Review Date: 11/15/2009
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).