Hyperkalemia

Hyperkalemia is a topic covered in the 5-Minute Emergency Consult.

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Basics

Description

  • Hyperkalemia: Serum potassium >5.5 mEq/L
    • Mild: 5.5–6.4 mEq/L
    • Moderate: 6.5–7.5 mEq/L
    • Severe: >7.5 mEq/L
  • 98% of total body potassium is found intracellularly
  • Cellular potassium gradient is maintained by Na-K ATPase
  • Functions of intra and extracellular potassium gradient:
    • Resting cell membrane potential
    • Cardiac activity
    • Muscle and nerve activity

Etiology

  • Increased intake:
    • Potassium supplementation
    • Food high in potassium
    • RBC transfusion
  • Impaired excretion:
    • Acute kidney injury
    • Hypoaldosteronism
    • Primary renal tubular defect
  • Pseudohyperkalemia:
    • Hemolysis
    • IV fluid with potassium
    • Cooling of blood specimen
  • Medication induced:
    • ACE inhibitors
    • Potassium sparing diuretics
    • Penicillin G potassium

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Basics

Description

  • Hyperkalemia: Serum potassium >5.5 mEq/L
    • Mild: 5.5–6.4 mEq/L
    • Moderate: 6.5–7.5 mEq/L
    • Severe: >7.5 mEq/L
  • 98% of total body potassium is found intracellularly
  • Cellular potassium gradient is maintained by Na-K ATPase
  • Functions of intra and extracellular potassium gradient:
    • Resting cell membrane potential
    • Cardiac activity
    • Muscle and nerve activity

Etiology

  • Increased intake:
    • Potassium supplementation
    • Food high in potassium
    • RBC transfusion
  • Impaired excretion:
    • Acute kidney injury
    • Hypoaldosteronism
    • Primary renal tubular defect
  • Pseudohyperkalemia:
    • Hemolysis
    • IV fluid with potassium
    • Cooling of blood specimen
  • Medication induced:
    • ACE inhibitors
    • Potassium sparing diuretics
    • Penicillin G potassium

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