Hyperkalemia: What to know about high blood levels of potassium

high levels of potassium

Potassium is an important mineral with numerous functions in the body. More than 95 percent of the potassium in your body is inside your cells, with the remainder in the fluids outside your cells, including your blood. While this mineral is needed for fluid balance and as a blood buffer, too much potassium can result in a medical problem called hyperkalemia.  Hyperkalemia is when you have too much potassium in your blood. Although mild cases of hyperkalemia may not produce any symptoms and are usually easy to treat, a more severe case that is not treated can be dangerous leading to serious heart problems such as fatal cardiac arrhythmias or having an abnormal heart rhythm.

Who is at risk for hyperkalemia?

There are several risks factors or causes of the condition of too much potassium in the blood. Here are the most common causes most people who develop hyperkalemia have:

  • Chronic kidney disease: An important job of the kidneys is to balance the amount of potassium taken in with the amount lost in the urine. Potassium found in various foods and beverages, when digested will eventually be filtered by the kidneys and lost through the urine. In the early stages of chronic kidney disease, the kidneys can often take care of high potassium levels. But as kidney function worsens, they become unable to remove enough of the mineral from the body, which is why advanced kidney disease is a common cause of hyperkalemia.
  • A diet high in potassium: Eating too many foods high in potassium can cause hyperkalemia, especially in people with advanced kidney disease. Foods such as bananas, cantaloupe, apricots, prunes, raisins, lentils, broccoli, black beans, peanut butter, milk, and yogurt, are examples of foods high in potassium of more than 200 mg per portion.
  • Drugs that prevent the kidneys from losing enough potassium: Certain drugs, like medications that lower blood pressure, can prevent your kidneys from removing enough potassium into the urine leading to an excess of potassium in the blood.

Other less common causes of hyperkalemia include:

  • Addisons disease, a condition that does not make enough of certain hormones
  • Alcoholism or heavy drug use that breaks down muscle fibers, releasing potassium
  • Diabetes, especially when not properly controlled and managed
  • Burns or other serious injuries
  • Massive injury resulting in muscle damage
  • HIV and certain other infections
  • High-volume blood transfusions
  • Taking extra potassium, such as salt substitutes or supplements

Symptoms of hyperkalemia

Since many patients do not show symptoms of this disorder, is why it’s important to understand the causes and risk factors. Often, there are very mild and non-specific symptoms that a person may not connect to hyperkalemia initially. These symptoms may include muscle weakness, numbness, tingling, nausea, or other unusual feelings. Any symptoms that do arise usually develop slowly over many weeks or months.

If a person has a more serious case of hyperkalemia or if it comes on suddenly due to very high levels of blood potassium, then the following symptoms may include:

  • Chest pain
  • Heart palpitations
  • Shortness of breath
  • Nausea and vomiting
  • Irregular heartbeat

Laboratory data and electrocardiographic changes are other ways to diagnose hyperkalemia. For most people, potassium levels should be between 3.5 and 5.0 millimoles per liter (mmol/L). It is considered to be hyperkalemia if the potassium level is greater than 5.5 mmol/L.

Treating hyperkalemia

When a person is diagnosed with hyperkalemia, depending on how high the potassium levels are, will determine which course of action to take in treating it. For someone whose potassium levels are very high or if there are concerning changes in an electrocardiogram, then emergency treatment will be necessary. This may include supplying calcium via IV to treat the effects on muscles and the heart or administering glucose and insulin also via IV to reduce potassium levels correcting the situation. Sometimes a diuretic will be administered to help remove potassium from a person’s body.

If the kidneys are failing, then kidney dialysis is another treatment also helping remove potassium from the intestines before being absorbed.

For someone with more mild elevation of potassium or who is in an earlier stage of chronic kidney disease, they will be advised to make dietary changes that can help prevent or treat high potassium levels. This would be called following a low-potassium diet.

Ask your healthcare provider or a dietitian how much potassium to have each day. Eating too much can be harmful but it is also harmful to eat not enough. Portion size is very important and that’s why seeing a dietitian is very helpful in creating a meal plan providing the right amount of potassium to meet individual needs.

Here are some foods a doctor or dietitian may advise to avoid or limit:

  • Asparagus
  • Avocados
  • Potatoes
  • Tomato sauce
  • Winter squash
  • Pumpkin
  • Cooked spinach
  • Oranges and orange juice
  • Nectarines
  • Kiwifruit
  • Bananas
  • Cantaloupe
  • Honeydew melon
  • Prunes, raisins, and other dried fruit

Dr. David Samadi is the Director of Men’s Health and Urologic Oncology at St. Francis Hospital in Long Island. He’s a renowned and highly successful board-certified Urologic Oncologist Expert and Robotic Surgeon in New York City, regarded as one of the leading prostate surgeons in the U.S., with vast expertise in prostate cancer treatment and Robotic-Assisted Laparoscopic Prostatectomy.  Dr. Samadi is a medical contributor to NewsMax TV and is also the author of The Ultimate MANual, Dr. Samadi’s Guide to Men’s Health and Wellness, available online both on Amazon and Barnes & Noble. Visit Dr. Samadi’s websites at robotic oncology and prostate cancer 911.

Hyperkalemia: What to know about high blood levels of potassium
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