Hyperkalemia: Causes, Symptoms, and Effective Treatment Methods
Potassium is one of the primary electrolytes in intracellular fluid, playing a key role in the proper functioning of the nervous system and heart muscle. However, an excess of potassium can lead to serious health consequences, including cardiac arrest. Hyperkalemia, which is an abnormally high potassium level in the blood, can develop subtly, making it easy to overlook.
How can you recognize the symptoms of too much potassium, and what are the most common causes of hyperkalemia? What does the treatment of this electrolyte imbalance look like, and are there ways to lower potassium levels in the body at home?
Table of contents
- What is hyperkalemia?
- Classification of hyperkalemia severity
- Symptoms of high potassium in the blood
- Causes and effects of hyperkalemia
- Diagnosing and treating hyperkalemia
- Preventing hyperkalemia
- Foods to avoid with high potassium
- How to lower potassium levels at home?
- Hyperkalemia - a serious electrolyte disorder that should never be ignored
What is hyperkalemia?
Potassium is one of the most crucial ions in the body’s homeostasis. About 90% of this element is found inside cells, with the remaining 10% located in extracellular spaces, including tissue fluids and blood. Potassium is responsible for proper nerve function, supports muscle activity, and regulates blood pressure. It also affects protein synthesis, stabilizes cell membranes, and accelerates the removal of waste products from metabolism.
The normal range of potassium levels in blood serum is between 3.5 and 5.0 mmol/l. When potassium levels exceed 5.5 mmol/l, it is referred to as hyperkalemia or hyperpotassemia. This electrolyte imbalance can pose a serious health threat, which is why it’s important to recognize the symptoms of high potassium and take appropriate action if levels exceed the normal range.
The kidneys play a critical role in maintaining potassium balance by excreting most of this ion. Therefore, proper kidney function is one of the key factors affecting potassium homeostasis in the body. Impaired potassium excretion due to kidney dysfunction is one of the most common causes of hyperkalemia.
Classification of hyperkalemia severity
Hyperkalemia is classified into three stages based on severity:
- Mild (5.5-6.0 mmol/l)
- Moderate (6.1-7.0 mmol/l)
- Severe (>7.1 mmol/l)
Excessive potassium can lead to arrhythmias, muscle weakness, and other severe symptoms, which is why it’s important to monitor potassium levels in the blood. Levels exceeding 7.5 mmol/l are considered life-threatening and require immediate medical intervention.
Symptoms of high potassium in the blood
Symptoms of excess potassium are often nonspecific and may appear only in advanced stages of hyperkalemia. Early detection of the condition can prevent dangerous complications, such as reduced cardiac output, ventricular fibrillation, or cardiac arrest.
Symptoms of excess potassium:
- Fatigue and apathy
- Decreased muscle strength and muscle cramps
- Tingling and numbness in the limbs
- Bradycardia (slow heart rate)
- Sensory disturbances
- Irregular heartbeat
- Confusion, seizures
The symptoms of hyperkalemia can vary widely, depending on the potassium levels in the blood. Mild cases may be asymptomatic. The most common symptoms affect three main systems: the central nervous system, the cardiovascular system, and the muscular system. In extreme cases, hyperkalemia can lead to unconsciousness, circulatory collapse, and even death.
Causes and effects of hyperkalemia
Potassium imbalance can result from various factors. One of the most common causes of elevated potassium levels is impaired potassium excretion due to kidney dysfunction, making hyperkalemia common among people with acute or chronic kidney failure.
Other causes of high potassium in the blood include:
- Adrenal insufficiency and aldosterone deficiency
- Excessive potassium intake through diet or supplements
- Potassium transport disorders (e.g., metabolic acidosis, insulin deficiency, autonomic neuropathy)
- Release of potassium from cells (e.g., tumor lysis syndrome, poisoning, sepsis)
- Medications that block potassium excretion (such as ACE inhibitors, angiotensin receptor blockers, potassium-sparing diuretics, immunosuppressants, non-steroidal anti-inflammatory drugs (NSAIDs), and some antibiotics)
In addition to chronic kidney disease, factors that increase the risk of hyperkalemia include old age, heart disease, worsening kidney function, endocrine disorders, and the use of medications affecting potassium metabolism.
Diagnosing and treating hyperkalemia
The diagnosis of hyperkalemia is made by measuring potassium levels in the blood and assessing the clinical symptoms reported by the patient. Before starting treatment, it’s important to rule out pseudohyperkalemia, which is a false increase in potassium levels due to hemolysis of the blood sample (breakdown of red blood cells caused by errors in blood collection or storage).
Treatment of hyperkalemia depends primarily on the severity of the electrolyte imbalance and the underlying cause of high potassium. In mild cases, medications that bind potassium (such as diuretics that promote potassium excretion like furosemide) are commonly used.
In cases of significant potassium elevation, pharmacological treatments are used to lower potassium levels and shift it into cells. In life-threatening acute hyperkalemia, intravenous calcium, loop diuretics, and ion-exchange resins are administered. In severe cases or in patients with kidney failure, hemodialysis may be necessary.
Preventing hyperkalemia
Regular monitoring of potassium levels is key to preventing hyperkalemia. This is particularly important for individuals with chronic kidney disease, diabetes, heart failure, or those taking medications that elevate potassium levels.
In addition to monitoring potassium levels, the following preventive measures are important:
- A diet low in potassium
- Maintaining proper hydration
- Avoiding potassium-containing supplements without medical supervision
Foods to avoid with high potassium
Now that you understand the symptoms and treatment of hyperkalemia, let’s focus on dietary recommendations for individuals with excessive potassium in the body. What should be avoided in a high-potassium diet?
If your potassium levels are elevated, it’s important to limit the intake of foods that are high in potassium. The following foods should be eliminated from the diet:
- Potatoes
- Sweet potatoes
- Bananas
- Avocados
- Nuts
- Cocoa and chocolate
- Dried fruits (raisins, apricots)
- Legumes and seeds
- Vegetable and fruit juices
Additionally, cooking techniques that help reduce potassium content, such as soaking vegetables and potatoes in water before cooking, can be useful. It's also important to avoid frying or baking without prior boiling.
How to lower potassium levels at home?
In mild cases, the treatment of high potassium can be supported with natural methods, provided they are recommended by a doctor. How can you lower potassium at home?
Focus on a diet low in potassium, incorporating foods such as:
- Apples
- Pears
- Blueberries
- Cherries
- Cabbage
- Zucchini
- Cauliflower
- Semolina
- White rice
- Wheat bread
If kidney function is normal, it’s also important to drink adequate amounts of water. Avoid isotonic drinks, vegetable juices, broths, and strong coffee.
It’s also essential to monitor protein intake (as excess protein can contribute to further electrolyte imbalances, especially in cases of kidney dysfunction), carefully read food labels (to avoid products containing added potassium), and reduce salt intake containing potassium chloride.
Hyperkalemia - a serious electrolyte disorder that should never be ignored
Potassium is an essential element for the proper functioning of the body. In addition to regulating water and electrolyte balance, it is involved in nerve impulse transmission, blood pressure regulation, and various enzymatic reactions.
Hyperkalemia, or excessive potassium in the body, is a serious electrolyte disturbance. In many cases, the increase in potassium levels can be prevented by regularly monitoring its concentration, which is particularly important for individuals with kidney disease or those taking medications that inhibit its excretion.
Apart from controlling potassium levels, adopting a healthy, balanced diet and staying well-hydrated by drinking plenty of water are also important preventive measures. If hyperkalemia is suspected, consult a doctor immediately to determine the appropriate course of action and begin treatment.
Bibliography: