Too much potassium in the blood (hyperkalaemia)

What is it about ?

Potassium is a mineral that has an important role in the human body. It plays a role in particular in the transmission of nerve impulses and muscle contraction. The amount of potassium in the body is controlled by the kidneys. Too much potassium in the blood (hyperkalaemia) or lack potassium in the blood (hypokalaemia) causes symptoms. Normally, the level of potassium in the blood is between 3.5 and 5.1 millimoles per liter (mmol / liter).

Potassium intake comes from food and drink. The kidneys must pass potassium in the urine in just enough quantity so that the level of potassium in the blood and in the cells of the body is never too high or too low. It is rare for a healthy person to have too much potassium. It is indeed practically impossible to consume too much potassium with food or drink. The kidneys eliminate any excess in the urine. An increase in the level of potassium in the blood (serum potassium) can occur when the kidneys are not working well.

Where does it occur?

Hyperkalemia is more common in three groups:

• People in renal failure, situation in which the kidneys are not working as well and do not remove excess potassium from the blood in the urine. Kidney failure can occur suddenly, for example due to dehydration from severe vomiting or profuse diarrhea, or after an accident that caused severe damage to the muscles. Kidney failure can also develop gradually as a result of aging.
• People who take certain medications which lower your blood pressure (hypotensive drugs) (certain diuretics, such as spironolactone, or medicines that work on the kidneys, such as angiotensin converting enzyme inhibitors (ACEIs)), or anti-inflammatory drugs for kidney disease.
• A more rarely affected group is that of patients with addison’s disease, characterized by a deficiency in hormones which regulate the supply of potassium in the kidneys and its evacuation in the urine.

How to recognize it?

An increased level of potassium in the blood can cause muscle weakness. In addition, anomalies appear at theelectrocardiogram (recording of heart activity). In the event of severe hyperkalaemia (potassium greater than 7.5 mmol / liter), there is a risk of severe heart rhythm disturbances which can cause heart failure.

How is the diagnosis made?

The doctor notices an increase in the level of potassium blood test. The collection tube should be analyzed as quickly as possible in the laboratory, because if you wait too long, the values ​​may increase and give a falsely increased result.

What can you do ?

If you belong to a risk group, it may be helpful to limit the intake of potassium through food. Potassium is found in virtually all foods. It is mostly found in the following foods:

• Vegetables: artichokes, chard, spinach, fennel, cabbage,…;
• Fruits: bananas, kiwis, apricots, plums, melon, avocados,…;
• Potatoes (including fries and crisps);
• Dried and oleaginous fruits: walnuts, hazelnuts, almonds, pistachios, peanuts,…;
• Dried fruits: grapes, apricots, prunes, dates, figs,…;
• Dried vegetables: chickpeas, beans, split peas,…;
• Whole grains and wholemeal starches: wholemeal bread, gray bread, wholemeal rice, wholemeal pasta, etc.
• Instant coffee ;
• Juice ;
• Cocoa products;
• False salt.

For a suitable diet low in potassium, you can contact a dietitian or a nutritionist. If you have a kidney disease, always consult your doctor before taking any new medicine.

What can the doctor do?

Depending on the severity of the hyperkalaemia, the doctor will treat you himself or send you to the hospital. In any case, you should immediately stop the drug responsible for the hyperkalaemia. If you are dehydrated, you will need fluid intake.

• If there is no immediate danger to life, the doctor may try to reduce the level of potassium in the blood with pills or enemas.
• If the level of potassium in the blood is much too high, hospitalization is necessary to administer infusion therapy. In severe cases, it is sometimes necessary to temporarily resort to kidney dialysis.

Want to know more?

• Potassium-sparing diuretics – CBIP – Belgian Center for Pharmacotherapeutic Information
• Spironolactone – CBIP – Belgian Center for Pharmacotherapeutic Information
• Converting enzyme inhibitors (ACEI) – CBIP – Belgian Center for Pharmacotherapeutic Information
• Non-steroidal anti-inflammatory drugs – CBIP – Belgian Center for Pharmacotherapeutic Information

Are you looking for more specialized help?

• Find a registered dietitian – Professional Union of French-speaking dieticians
• Find a nutritionist doctor – Belgian Society of Nutritionist Doctors

Source

Foreign clinical practice guide ‘Hyperkalaemia’ (2000), updated on 07.08.2017 and adapted to the Belgian context on 23.04.2019 – ebpracticenet