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High potassium level

High potassium level is a problem in which the amount of potassium in the blood is higher than normal. The medical name of this condition is hyperkalemia.

Alternative Names

Hyperkalemia; Potassium - high; High blood potassium

Causes

Potassium is needed for cells to function properly. You get potassium through food. The kidneys remove excess potassium in the urine to keep a proper balance of this mineral in the body.

If your kidneys are not working well, they may not be able to remove the proper amount of potassium. As a result, potassium can build up in the blood. This buildup can be due to:

  • Addison's disease
  • Burns over large areas of the body
  • Certain medicines such as water pills (diuretics) or blood pressure drugs
  • Damage to muscle and other cells from certain street drugs, alcohol abuse, untreated seizures, surgery, crush injuries and falls, certain chemotherapy, or certain infections
  • Disorders that cause blood cells to burst (hemolytic anemia )
  • Severe bleeding from the stomach or intestines
  • Taking extra potassium, such as salt substitutes or supplements
  • Tumors

Symptoms

There are often no symptoms with a high level of potassium. When symptoms do occur, they may include:

  • Nausea
  • Slow, weak, or irregular pulse
  • Sudden collapse, when the heartbeat gets too slow or even stops

Exams and Tests

The doctor will perform a physical exam and ask about your symptoms.

Tests that may be ordered include:

  • Electrocardiogram (ECG) Potassium level

Your doctor will likely check your blood potassium level and do kidney blood tests on a regular basis if you:

  • Have been prescribed extra potassium
  • Have chronic kidney disease
  • Take medications to treat heart disease or high blood pressure
  • Use salt substitutes

Treatment

You will need emergency treatment if your potassium level is very high, or if you have danger signs, such as changes in an ECG .

Emergency treatment may include:

  • Calcium given into your veins (IV) to treat the muscle and heart effects of high potassium levels
  • Glucose and insulin given into your veins (IV) to help lower potassium levels long enough to correct the cause
  • Kidney dialysis if your kidney function is poor
  • Medications that help remove potassium from the intestines before it is absorbed
  • Sodium bicarbonate if the problem is caused by acidosis
  • Water pills (diuretics) to decrease total potassium

Changes in your diet can help both prevent and treat high potassium levels. You may be asked to:

  • Limit or avoid asparagus, avocados, potatoes, tomatoes or tomato sauce, winter squash, pumpkin, and cooked spinach
  • Limit or avoid oranges and orange juice, nectarines, Kiwis, raisins, or other dried fruit, bananas, cantaloupe, honeydew, prunes, and nectarines
  • Avoid taking salt substitutes if you are asked to eat a low-salt diet

Your doctor may make the following changes to your medicines:

  • Reduce or stop potassium supplements
  • Stop or change the doses of medicines you are taking, such as ones for heart disease and high blood pressure
  • Take a certain type of water pill to reduce potassium and fluid levels if you have chronic kidney failure

Follow your health care provider's directions when taking your medicines:

  • Do not stop or start taking medicines without first talking to your health care provider
  • Take your medicines on time
  • Always tell your health care provider about any other medicines, vitamins, or supplements you are taking

References

Seifter JL. Potassium disorders. In: Goldman L, Schafer, AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 119.

Updated: 11/7/2013

Brent Wisse, MD, Associate Professor of Medicine, Division of Metabolism, Endocrinology & Nutrition, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.


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