Hyperkalemia Questions & Answers

Updated: Jun 20, 2018
  • Author: Eleanor Lederer, MD, FASN; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Questions & Answers

Overview

How is hyperkalemia (high serum potassium level) defined?

When is surgery indicated in the treatment of hyperkalemia (high serum potassium level)?

What are the symptoms of hyperkalemia (high serum potassium level)?

What are the physical findings in hyperkalemia (high serum potassium level)?

What causes hyperkalemia (high serum potassium level)?

Which tests should be performed when symptoms suggest hyperkalemia (high serum potassium level)?

Which secondary tests may be useful in hyperkalemia (high serum potassium level)?

What is the role of ECG in hyperkalemia (high serum potassium level)?

How are ECG findings likely to change as blood potassium levels increase in hyperkalemia?

Which factors affect the choice of therapy for hyperkalemia (high serum potassium level)?

What is the treatment for moderate hyperkalemia?

What are the treatment options for severe hyperkalemia?

Which medications are used to increase potassium excretion?

At what serum potassium concentration is hyperkalemia (high serum potassium level) diagnosed?

Which test should be performed to confirm an incidental lab finding of hyperkalemia (high serum potassium level)?

When is ECG required in suspected hyperkalemia (high serum potassium level)?

How is hyperkalemia (high serum potassium level) treated?

What is the reference range of serum potassium?

How is potassium obtained by the body?

How is potassium excreted?

What is the role of sodium reabsorption in potassium secretion?

What is the role of signaling molecules in the regulation of sodium and potassium transport?

What increases renal potassium excretion?

What decreases renal potassium excretion?

How do the kidneys adapt to alterations in potassium intake?

How does chronic kidney disease affect potassium homeostasis?

How are serum potassium levels determined?

What factors affect extracellular or intracellular potassium levels?

What regulatory factors stabilize serum potassium levels?

What is the role of GI-renal signals in the pathophysiology of potassium excretion?

What causes hyperkalemia (high serum potassium levels)?

What are the risk factors for development of hyperkalemia (high serum potassium level)?

When can excessive potassium intake alone cause hyperkalemia (high serum potassium level)?

What are the most common causes of decreased excretion of potassium in hyperkalemia (high serum potassium level)?

What causes potassium to shift from the intracellular to the extracellular space?

Which clinical situations suggest a shift of potassium from the intracellular to the extracellular space?

Can epsilon aminocaproic acid (EACA) cause hyperkalemia (high serum potassium levels)?

What are cardiac and skeletal muscle effects of hyperkalemia (high serum potassium levels)?

What is the etiology of hyperkalemia (high serum potassium levels)?

What causes increased potassium intake in patients with hyperkalemia (high serum potassium level)?

What causes decreased potassium excretion in patients with hyperkalemia (high serum potassium level)?

Which disorders cause type IV renal tubular acidosis, resulting in hyperkalemia (high serum potassium level)?

Which factors can shift potassium into the extracellular space?

How does hypertonicity lead to hyperkalemia (high serum potassium level)?

Does aldosterone deficiency cause hyperkalemia (high serum potassium level)?

Does toad venom cause hyperkalemia (high serum potassium level)?

Which genetic disorders may result in hyperkalemia (high serum potassium level)?

How does glomerulopathy with fibronectin deposits (GFND) cause hyperkalemia (high serum potassium level)?

How do disorders of steroid metabolism and mineralocorticoid receptors cause hyperkalemia (high serum potassium level)?

How does congenital hypoaldosteronism cause hyperkalemia?

What is the role of type I pseudohypoaldosteronism (PHAI) in the development of hyperkalemia (high serum potassium level)?

What is the role of type I pseudohypoaldosteronism (PHAI) caused by mutations in the NR3C2 in the development of hyperkalemia (high serum potassium level)?

What is the role of type II pseudohypoaldosteronism (PHAII) (Gordon syndrome) in the development of hyperkalemia (high serum potassium level)?

How does type II pseudohypoaldosteronism (PHAII) (Gordon syndrome) affect hyperkalemia (high serum potassium level)?

How do chloride homeostasis disorders cause hyperkalemia (high serum potassium levels)?

How does nephronophthisis cause hyperkalemia (high serum potassium levels)?

What causes hyperkalemic period paralysis (HYPP)?

Why are people with diabetes mellitus at higher risk for developing hyperkalemia (high serum potassium level)?

In what populations is hyperkalemia (high serum potassium level) most common?

What is the prevalence of hyperkalemia (high serum potassium level) among children?

Why are military recruits, individuals with sickle cell traits, and people who abuse drugs at risk for hyperkalemia (high serum potassium level)?

What clinical factors increase the risk of hyperkalemia (high serum potassium level) in patients with diabetes mellitus?

Are individuals taking ACE inhibitors at increased risk of developing hyperkalemia (high serum potassium level)?

Why are patients with cardiovascular issues at higher risk of developing hyperkalemia (high serum potassium level)?

What is the global prevalence of hyperkalemia (high serum potassium level)?

What is the prevalence of hyperkalemia (high serum potassium level) among different age groups?

Is hyperkalemia (high serum potassium level) more common in males or females?

What is the prognosis for patients with hyperkalemia (high serum potassium level)?

What is the mortality rate associated with severe hyperkalemia?

Presentation

What are the symptoms of hyperkalemia?

What are possible causes of excessive potassium intake in patients with hyperkalemia (high serum potassium level)?

What are possible causes of excessive potassium intake in hospitalized patients?

What are possible causes of decreased potassium excretion?

Which medications can impair renal potassium excretion?

What causes shift of potassium into the extracellular space in hyperkalemia (high serum potassium level)?

What should be the focus of the medical history in a child with acute hyperkalemia (high serum potassium levels)?

What medical or family history details may be helpful in the diagnosis of a child with acute hyperkalemia (high serum potassium levels)?

What is the purpose of a physical exam in hyperkalemia (high serum potassium level)?

DDX

What causes pseudohyperkalemia (falsely high elevations of serum potassium concentration)?

What are the differential diagnoses for Hyperkalemia?

Workup

What tests should be performed first in the evaluation of suspected hyperkalemia (high serum potassium level)?

Is measurement of trans-tubular potassium gradient (TTKG) useful in the evaluation of hyperkalemia (high serum potassium level)?

What supplemental tests may be useful in the evaluation of hyperkalemia (high serum potassium level)?

What is the relationship between the serum potassium level and symptoms of hyperkalemia (high serum potassium level)?

What do ECG findings indicate in hyperkalemia (high serum potassium level)?

What are the typical ECG findings in severe hyperkalemia (high serum potassium levels)?

What is the Cockroft-Gault equation for determining renal function?

Which urine potassium levels indicate impaired renal excretion?

How accurate is a spot urine potassium measurement?

What is the trans-tubular potassium gradient (TTKG)?

What is the equation for trans-tubular potassium gradient (TKKG)?

What do trans-tubular potassium gradient (TKKG) measurements indicate in hyperkalemia (high serum potassium level)?

When is the measurement of the trans-tubular potassium gradient (TKKG) considered valid in hyperkalemia (high serum potassium level)?

Treatment

How is the treatment approach for hyperkalemia (high serum potassium level) determined?

How is moderate hyperkalemia (high serum potassium levels) treated?

How is severe hyperkalemia (high serum potassium levels) treated?

When is hemodialysis indicated in the treatment of hyperkalemia (high serum potassium level)?

What tests should be performed to determine the cause of hyperkalemia (high serum potassium level)?

How is hyperkalemia (high serum potassium level) treated in the prehospital setting?

What tests are required in the emergency department (ED) when hyperkalemia (high serum potassium level) is suspected?

Which drugs should be discontinued during the emergency management of hyperkalemia (high serum potassium level)?

When is cation exchange resin administered in the emergency treatment of hyperkalemia (high serum potassium level)?

How does overcorrection of potassium occur?

When should treatment begin in symptomatic hyperkalemia (high serum potassium levels)?

What is the first step in the medical treatment of hyperkalemia (high serum potassium level)?

How are sources of potassium intake identified and removed in the treatment of hyperkalemia ((high serum potassium levels)?

How is cellular potassium uptake enhanced in the treatment of hyperkalemia (high serum potassium levels)?

How is metabolic acidosis corrected in patients with hyperkalemia (high serum potassium level)?

Are parenteral isoproterenol and albuterol used in the treatment of hyperkalemia (high serum potassium level)?

How is potassium excretion increased in the treatment of hyperkalemia (high serum potassium level)?

How is sodium polystyrene sulfonate (SPS) used in the treatment of hyperkalemia (high serum potassium level)?

Is sodium polystyrene sulfonate (SPS) a safe and effective treatment in patients with hyperkalemia (high serum potassium level)?

How is patiromer sorbitex calcium (Veltassa) used in the treatment of hyperkalemia (high serum potassium level)?

Is patiromer sorbitex calcium (Veltassa) safe and effective in the treatment of hyperkalemia (high serum potassium level)?

When is emergency dialysis indicated in the treatment of hyperkalemia (high serum potassium level)?

What is the final step in the medical treatment of hyperkalemia (high serum potassium level)?

When is surgery indicated for hyperkalemia (high serum potassium level)?

What are possible complications of hyperkalemia (high serum potassium level) treatment?

What are the diet and activity recommendations for patients with hyperkalemia (high serum potassium level)?

How can hyperkalemia (high serum potassium level) be prevented?

Which specialists should be consulted in the management of hyperkalemia (high serum potassium level)?

How and when should patients with hyperkalemia (high serum potassium level) be monitored?

Medications

Which medications in the drug class Calcium salts are used in the treatment of Hyperkalemia?

Which medications in the drug class Beta-adrenergic agonists are used in the treatment of Hyperkalemia?

Which medications in the drug class Antidiabetics, Insulins are used in the treatment of Hyperkalemia?

Which medications in the drug class Diuretics, Loop are used in the treatment of Hyperkalemia?

Which medications in the drug class Potassium Binders are used in the treatment of Hyperkalemia?

Which medications in the drug class Alkalinizing Agents are used in the treatment of Hyperkalemia?

Which medications in the drug class Electrolytes are used in the treatment of Hyperkalemia?