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Medical Author:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

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.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

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.

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In this Article

• What is hyperkalemia?
• How does hyperkalemia affect the body?
• What are the symptoms of hyperkalemia?
• What causes hyperkalemia?
• Kidney dysfunction
• Diseases of the adrenal gland
• Potassium shifts
• Medications
• How is hyperkalemia diagnosed?
• How is hyperkalemia treated?
• Patient Comments: Hyperkalemia - Symptoms
• Patient Comments: Hyperkalemia - Treatment
• Patient Comments: Hyperkalemia - Diagnosis
• Find a local Internist in your town
• Hyperkalemia Index

Potassium supplements, salt substitutes that contain potassium and other medications can cause hyperkalemia.

In normal individuals, healthy kidneys can adapt to excessive oral intake of potassium by increasing urine excretion of potassium, thus preventing the development of hyperkalemia. However, taking in too much potassium (either through foods, supplements, or salt substitutes containing potassium) can cause hyperkalemia if there is kidney dysfunction or if the patient is taking medications that decrease urine potassium excretion such as ACE inhibitors and potassium-sparing diuretics.

Examples of medications that decrease urine potassium excretion include:

• ACE inhibitors,
  
  
• ARBs,
  
  
• NSAIDs,
  
  
• potassium-sparing diuretics such as:
   
  • spironolactone (Aldactone),
     
  • triamterene (Dyrenium), and
     
  • trimethoprim-sulfamethoxazole (Bactrim).

Even though mild hyperkalemia is common with these medications, severe hyperkalemia usually do not occur unless these medications are given to patients with kidney dysfunction.

Blood is withdrawn from a vein (like other blood tests). The potassium concentration of the blood is determined in the laboratory. If hyperkalemia is suspected, an electrocardiogram (ECG or EKG) is often performed, since the ECG may show changes typical for hyperkalemia in moderate to severe cases. The ECG will also be able to identify cardiac arrhythmias that result from hyperkalemia.