Hyperkalemia

Research output: Contribution to journalReview article

78 Scopus citations

Abstract

Hyperkalemia is a potentially life-threatening metabolic problem caused by inability of the kidneys to excrete potassium, impairment of the mechanisms that move potassium from the circulation into the cells, or a combination of these factors. Acute episodes of hyperkalemia commonly are triggered by the introduction of a medication affecting potassium homeostasis; illness or dehydration also can be triggers. In patients with diabetic nephropathy, hyperkalemia may be caused by the syndrome of hyporeninemic hypoaldosteronism. The presence of typical electrocardiographic changes or a rapid rise in serum potassium indicates that hyperkalemia is potentially life threatening. Urine potassium, creatinine, and osmolarity should be obtained as a first step in determining the cause of hyperkalemia, which directs long-term treatment. Intravenous calcium is effective in reversing electrocardiographic changes and reducing the risk of arrhythmias but does not lower serum potassium. Serum potassium levels can be lowered acutely by using intravenous insulin and glucose, nebulized beta 2 agonists, or both. Sodium polystyrene therapy, sometimes with intravenous furosemide and saline, is then initiated to lower total body potassium levels.

Original languageEnglish (US)
Pages (from-to)283-290
Number of pages8
JournalAmerican family physician
Volume73
Issue number2
StatePublished - Jan 15 2006

ASJC Scopus subject areas

  • Family Practice

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  • Cite this

    Hollander-Rodriguez, J. C., & Calvert, J. F. (2006). Hyperkalemia. American family physician, 73(2), 283-290.