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High potassium level

Definition

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 disease
  • Burns over large areas of the body
  • Certain blood pressure lowering drugs, most often ACE inhibitors
  • 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
  • Some water pills (diuretics)

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. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 119.

Review Date:11/7/2013
Reviewed By: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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