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.
Adrenal glands are small glands located adjacent to the kidneys, and are
important in secreting hormones such as cortisol and aldosterone. Aldosterone
causes the kidneys to retain sodium and fluid while excreting potassium in the
urine. Therefore diseases of the adrenal gland, such as Addison's disease, that lead to decreased
aldosterone secretion can decrease kidney excretion of potassium, resulting in
body retention of potassium, and hence hyperkalemia.
Potassium shifts
Potassium can move out of and into cells. Our total body
potassium stores are approximately 50 mEq/kg of body weight. At any given time,
about 98% of the total potassium in the body is located inside of cells
(intracellular), with only 2% located outside of cells (in the blood circulation
and in the "extracellular" tissue). The blood tests for measurement of potassium levels
measure only the potassium that is outside of the cells. Therefore, conditions
that can cause potassium to move out of the cells into the blood circulation can
increase the blood potassium levels even though the total amount of potassium in
the body has not changed.
One example of potassium shift causing hyperkalemia is diabetic ketoacidosis.
Insulin is vital to patients with
type 1 diabetes.
Without insulin, patients with type 1 diabetes can develop severely elevated blood glucose levels.
Lack of insulin also causes the breakdown of fat cells, with the release of ketones into
the blood, turning the blood acidic (hence the term ketoacidosis). The acidosis
and high glucose levels in the blood work together to cause fluid and potassium
to move out of the cells into the blood circulation. Patients with diabetes
often also have diminished kidney capacity to excrete potassium into urine. The
combination of potassium shift out of cells and diminished urine potassium
excretion causes hyperkalemia.
Another cause of hyperkalemia is tissue destruction, dying cells release potassium into the blood circulation. Examples of tissue
destruction causing hyperkalemia include:
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.
Healthy Living Tips
This site complies with the