Potassium is an important mineral and electrolyte needed for many bodily functions. It helps regulate fluid balance throughout the body, maintain pH level and normalize blood pressure. Potassium also regulates your heartbeat by helping conduct nerve impulses and muscle contractions. Adequate intake of potassium for most adults is about 4,700 milligrams per day. Although uncommon, potassium levels can exceed normal limits (3.5 to 5.0 mEq/L) in the body, leading to hyperkalemia.
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The most common cause of hyperkalemia is kidney failure. Since the kidneys excrete potassium from the body, any impairment in normal kidney function can cause potassium levels to rise. Other diseases and conditions such as Addison’s disease, rhabdomyolysis, insulin deficiency, metabolic acidosis or extensive tissue or red blood cell damage can lead to hyperkalemia. Excessive use of potassium supplements, potassium-sparing diuretics or salt substitutes can also cause hyperkalemia. Many common drugs such as certain birth control pills, ACE inhibitors or nonsteroidal anti-inflammatory drugs can affect potassium levels. Finding the cause of hyperkalemia is important in determining the appropriate treatment options.
Symptoms of hyperkalemia include decreased blood pressure, stomach cramps, diarrhea, vomiting, irritability and fatigue. An irregular heart beat can occur when the muscles and nerves begin to malfunction. Some people report a tingling sensation in the hands, feet and tongue. In severe cases, hyperkalemia may cause respiratory failure or flaccid paralysis in the arms and legs. If not treated soon, hyperkalemia can have long-term effects on blood pressure, heart rhythm, digestion and kidney function. Contact your doctor immediately if you believe you are experiencing hyperkalemia.
The main goals of hyperkalemia treatment include stabilizing the heart rhythm and promoting potassium elimination from the blood. Calcium gluconate, sodium bicarbonate, diuretics, sorbitol or insulin will often be administered. These drugs work to either move potassium from the blood back into the cells or increase the amount of potassium excreted via urine or feces. In extreme cases, dialysis treatment has been used to resolve hyperkalemia. Serum potassium levels will be monitored closely throughout the course of treatment.
Once your doctor has identified the cause of the hyperkalemia, he or she may prescribe certain therapies to prevent its reoccurrence. Low potassium diets are often recommended to manage hyperkalemia. Foods that are high in potassium should be eaten in small amounts or avoided altogether. These include tomatoes, bananas, kiwi, mango, oranges and orange juice, avocados, potatoes, raisins, prunes, honeydew, cantaloupe, apricots, pumpkins and spinach. A registered dietitian can create a low potassium meal plan specifically for you. Your doctor may also need to adjust or discontinue any medications that are affecting your potassium level.