Hyperkalemia means high blood potassium, a condition that has a number of causes and adverse effects on your body. The most immediately dangerous effect is on your heart. High potassium can cause your heart to beat abnormally, and even interfere with the pumping of blood. It is important to consult with your physician for the diagnosis and treatment of mineral imbalances and other health conditions you may experience.
Hyperkalemia
Potassium enters the body through protein channels in your gastrointestinal tract. It is stored in higher levels inside your cells than outside the cells and is excreted by your kidneys. High blood potassium is caused by a shift of potassium out of the cells or failure to eliminate potassium through your kidneys. It can also be caused by excessive administration, as through an IV. High potassium effects electrical conduction in your cells, especially the heart and nerves.
Hyperkalemia and the Heart
Your heart uses electrochemical triggers to signal for contractions. Cells are relatively negatively charged at rest. Special protein channels open in heart muscle cells and sodium rushes in, rendering the cell temporarily positive and signaling for contraction. Separate channels then open, allowing potassium to rush out of your cells, restoring the negative charge in time for the next contraction. High levels of potassium in your blood discourage potassium from leaving the cell, keeping the heart cells more positive, and increasing contraction signals to the heart. This can cause you to experience abnormal heart rhythms, detectable by electrocardiogram (ECG), that may be treated with calcium gluconate.
Calcium Gluconate
Calcium, administered as calcium gluconate or calcium chloride, helps to stabilize the electrical activity of your heart in hyperkalemia. The mechanism for this action is unknown. The onset of action takes several minutes or less by careful intravenous administration, and the effects last up to an hour. Constant ECG monitoring is required.
Follow-Up
Calcium gluconate is administered for ECG changes in a high blood potassium state. If it is successful at normalizing the ECG, then steps are taken to lower your potassium level, since calcium gluconate only temporarily stabilizes your heart and does not address the underlying condition. The next step is to continue calcium gluconate as needed, and lower the potassium level. Options include diuretics to increase urine production leading to urinary excretion of potassium, and increasing excretion through your gastrointestinal tract with medications.
References
- "Harrison's Principles of Internal Medicine"; Anthony S Fauci, et al.; 17th Ed 2008
- "Basic and Clinical Pharmacology"; Bertram Katzung, et al.; 11th Ed 2009
Member Comments