Hyperkalemia

Hyperkalemia is a blood potassium level above the normal range, an electrolyte disturbance that can upset heart rhythm and muscle function. The kidneys normally clear excess potassium, so impaired kidney function is the commonest cause. Others include Addison disease, large burns, crush injuries, severe gut bleeding, potassium supplements or salt substitutes, and blood pressure medicines such as ACE inhibitors, angiotensin receptor blockers and mineralocorticoid receptor antagonists. Symptoms are often absent, but palpitations, a slow or irregular pulse, chest pain, breathlessness, nausea and muscle weakness can occur, and sudden collapse follows if the heartbeat fails. A serum potassium measurement confirms it, usually with kidney tests and an electrocardiogram. Severe cases need emergency treatment with intravenous calcium, insulin with glucose, diuretics, potassium-binding medicines or dialysis, and long-term care addresses the cause, diet and medicines because it can recur.

Seek urgent care for unusual bleeding or bruising, breathlessness at rest, or a swollen painful leg. See a doctor for persistent tiredness, pale skin, or any symptom of anaemia in a man or a woman after the menopause, which always needs a cause to be found. Call the local emergency number for any symptom that is sudden and severe. This page is a reference for healthcare professionals and does not replace an assessment.