Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
What Are Some of the Causes of Hyperkalemia (High Blood Potassium)
Excess potassium in the bloodstream can result from diseases of the kidneys or adrenal glands as well as from certain medications. Hyperkalemia can also be the result of potassium moving out of its usual location within cells into the bloodstream.
Any condition in which there is massive tissue destruction can result in elevated levels of blood potassium as the damaged cells release their potassium. Examples of tissue destruction include:
Hyperkalemia is common; it is diagnosed in up to 8% of
hospitalized patients in the U.S. Fortunately, most patients have mild
hyperkalemia (which is usually well tolerated). However, any
condition causing even mild
hyperkalemia should be treated to prevent progression into more severe
hyperkalemia. Extremely high levels of potassium in the blood (severe
hyperkalemia) can lead to cardiac arrest and
death. When not recognized and treated properly, severe hyperkalemia results in
a mortality rate of about 67%.
Technically, hyperkalemia means an abnormally elevated level of potassium in the blood.
The normal potassium level in the blood is 3.5-5.0 milliequivalents per liter
(mEq/L). Potassium levels between 5.1 mEq/L to 6.0 mEq/L reflect mild hyperkalemia.
Potassium levels of 6.1 mEq/L to 7.0 mEq/L are moderate hyperkalemia, and levels
above 7 mEq/L are severe hyperkalemia.
How does hyperkalemia affect the body?
Potassium is critical for the normal functioning of the
muscles, heart, and
nerves. It plays an important role in controlling activity of smooth muscle (such as
the muscle found in the digestive tract) and skeletal muscle (muscles
of the extremities and torso), as well as the muscles of the heart. It is also
important for normal transmission of electrical signals throughout the nervous
system within the body.
Normal blood levels of potassium are critical for maintaining normal heart
electrical rhythm. Both low blood potassium levels (hypokalemia) and high
blood potassium levels (hyperkalemia) can lead to
abnormal heart rhythms.
The most important clinical effect of hyperkalemia is
related to electrical rhythm of the heart. While mild hyperkalemia probably has
a
limited effect on the heart, moderate hyperkalemia can produce EKG changes (EKG
is an electrical reading of the heart muscles), and severe hyperkalemia can
cause suppression of electrical activity of the heart and can cause the heart to
stop beating.
Another important effect of hyperkalemia is interference
with functioning of the skeletal muscles. Hyperkalemic periodic paralysis is
a rare
inherited disorder in which patients can develop sudden onset of hyperkalemia which in turn causes
muscle paralysis. The reason for the muscle paralysis is not clearly understood,
but it is probably due to hyperkalemia suppressing the electrical activity of
the muscle.
Kidney failure can occur from an acute event or a chronic condition or disease. Prerenal kidney failure is caused by blood loss, dehydration, medication. Some of the renal causes of kidney failure are from sepsis, medications, rhabdomyolysis, multiple myeloma, and acute glomerulonephritis. Post renal causes of kidney failure include bladder obstruction, prostate problems, tumors, or kidney stones. Treatment options included diet, medications, or dialysis.
Diabetes mellitus is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue. Treatment of diabetes depends on the type.
An arrhythmia is an abnormal heart rhythm. With an arrhythmia, the heartbeats may be irregular or too slow (bradycardia), to rapid (tachycardia), or too early. When a single heartbeat occurs earlier than normal, it is called a prmature contraction.
Addison disease is a hormonal (endocrine) disorder involving destruction of the adrenal glands (small glands adjacent to the kidneys). Diseased glands can no longer produce sufficient adrenal hormones (specifically cortisol) necessary for normal daily body functions. Symptoms include weight loss, muscle weakness, fatigue, low blood pressure, and sometimes darkening of the skin. Treatment of Addison disease involves replacing, or substituting, the hormones that the adrenal glands are not making.
Potassium is an essential electrolyte necessary for cell function. Low potassium (hypokalemia) may be caused by diarrhea, vomiting, ileostomy, colon polyps, laxative use, diuretics, elevated corticosteroid levels, renal artery stenosis, and renal tubular acidosis, or other medications. Symptoms of low potassium include weakness, aches, and cramps of the muscles. Treatment is dependant upon the cause of the low potassium (hypokalemia).
Rhabdomyolysis is a rapid deterioration and destruction of skeletal muscle. Some of the causes of rhabdomyolysis include severe burns, muscle trauma, coma, seizures, electrolyte imbalance, medications (statins), viruses, bacteria. Treatment of rhabdomyolysis depends on the cause.
Burns are categorized by severity as first, second, or third degree. First degree burns are similar to a painful sunburn. The damage is more severe with second degree burns, leading to blistering and more intense pain. The skin turns white and loses sensation with third degree burns. Burn treatment depends upon the location, total burn area, and intensity of the burn.
High blood pressure can damage the kidneys and is one of the leading causes of kidney failure (end-stage renal kidney disease). Kidney damage, like hypertension, can be unnoticeable and detected only through medical tests. If you have kidney disease, you should control your blood pressure. Other treatment options include prescription medications.
Small chemicals in the body known as electrolytes are crucial for cells
to function. Potassium is one of the main electrolytes, and is concentrated
within the cells of the body. Only 2% of the body's total potassium is available
in the serum (the fluid part of the bloodstream that is not red or white blood
cells or platelets). Small changes in the serum levels of potassium can affect body
function. One of the important functions of potassium is maintenance of the cell
electrical potential. The serum bathes the cells, and if the serum potassium
level falls, cells with high electrical activity (for example, muscles and nerves) are
particularly affected.
Normal potassium levels measured in the serum range from
3.5 to 5.0 mEq/liter. Normal daily intake of potassium is 70-100 mEq (270 to 390
mg/dl), and requires the kidneys to remove that same amount each day. If more is
removed, the body's total potassium store will be decre...
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