What is Hyperkalemia?

Understand more about hyperkalemia and if you might be at risk.

High potassium (called “hyperkalemia”) is a medical problem in which you have too much potassium in your blood. Your body needs potassium. It is an important nutrient that is found in many of the foods you eat. Potassium helps your nerves and muscles, including your heart, work the right way. But too much potassium in your blood can be dangerous. It can cause serious heart problems.

What causes hyperkalemia?

The most common causes include:

Kidney Disease. Hyperkalemia can happen if your kidneys do not work well. It is the job of the kidneys to balance the amount of potassium taken in with the amount lost in urine. Potassium is taken in through the foods you eat and the liquids you drink. It is filtered by the kidneys and lost through the urine. In the early stages of kidney disease, the kidneys can often make up for high potassium. But as kidney function gets worse, they may not be able to remove enough potassium from your body. Advanced kidney disease is a common cause of hyperkalemia.
A diet high in potassium. Eating too much food that is high in potassium can also cause hyperkalemia, especially in people with advanced kidney disease. Foods such as cantaloupe, honeydew melon, orange juice, and bananas are high in potassium.
Drugs that prevent the kidneys from losing enough potassium. Some drugs can keep your kidneys from removing enough potassium. This can cause your potassium levels to rise.

Other (less common) causes include:

Taking extra potassium, such as salt substitutes or supplements.
A disorder called “Addison's disease”, which can occur if your body does not make enough of certain hormones. Hormones are chemicals produced by different glands and organs, including the kidneys, to trigger certain responses in your body.
Burns or other severe injuries. This occurs because your body, in response to severe burns or injuries releases extra potassium in your blood.
Poorly controlled diabetes.
When diabetes is not controlled, it has a direct effect on your kidneys which are responsible for balancing potassium in your body.

What are the symptoms of hyperkalemia?

Many people have few, if any, symptoms. If symptoms do appear, they are usually mild and non-specific. You may feel some muscle weakness, numbness, tingling, nausea, or other unusual feelings. It usually develops slowly over many weeks or months and is often mild. It can recur.

If hyperkalemia comes on suddenly and you have very high levels of potassium, you may feel heart palpitations, shortness of breath, chest pain, nausea, or vomiting. Sudden or severe hyperkalemia is a life-threatening condition. It requires immediate medical care.

How do I know if I have hyperkalemia?

A blood test can find the level of potassium in your blood. High potassium is usually found by chance during a routine blood test. Your healthcare provider will also give you a complete physical checkup. You will be asked about your medical history, your diet, and the medicines you take. This will help find out what caused your hyperkalemia and plan your treatment. It is important that you tell your healthcare provider about all the medicines you take, even over-the-counter products such as herbals and other supplements.

What is a “normal” level of potassium in blood?

For most people, the level of potassium in your blood should be between 3.5 and 5.0, depending on the laboratory that is used. Ask your healthcare provider what your potassium level is.

Can Hyperkalemia be treated?

Yes. You may need to follow a low-potassium diet. Your healthcare provider will tell you if any changes in your medicines are needed. You should not take salt substitutes, which are high in potassium. A dietician can help you create a meal plan that is low in potassium.

Some people may also need special medicine to help remove extra potassium from the body and keep it from coming back. This may include:

Water pills (diuretics) help rid your body of extra potassium. They work by making your kidney create more urine. Potassium is normally removed through urine.
Potassium binders often come in the form of a powder. They are mixed with a small amount of water and taken with food. When swallowed, they “bind” to the extra potassium in the bowels and remove it. Some potassium binders can also be taken by the rectum (an enema). You must follow the instruction carefully when taking potassium binders. For example, they must be taken at least six hours before or after taking other medicines. Potassium binders are not for use in children.

How much potassium is safe for me to eat?

If you have hyperkalemia—or if you are at risk for getting it— you may need to follow a low-potassium diet. Ask your healthcare provider or dietitian how much potassium is right for you. Eating too much can be harmful, but having too little can cause problems, too. Some people may need a little more; others may need less. High protein foods such as meat, fish, and chicken also have potassium, but you need a balance of high protein foods to stay healthy. Portion size is very important. A dietitian can help you create a meal plan that gives you the right amount of potassium and protein to meet your needs.