High potassium or hyperkalemia develops when the body produces more of this essential electrolyte than it needs to function correctly or if the body does not sufficiently process the produced amounts. Many factors can lead to high potassium, and these vary from mild to dangerous.
Hyperkalemia is usually linked to the kidneys because it is a sign they are not properly filtering potassium. A high potassium level can occur with chronic kidney disease, the gradual loss of kidney function over time. Hyperkalemia is most common with advanced kidney disease. As the kidneys stop working at full capacity, they cannot remove excess fluids and waste from the blood, and this leads to changes in electrolytes. Treatment for chronic kidney disease depends on the severity of the damage.
A high potassium level can be one of the first signs of acute kidney failure, which is serious but often reversible if treated promptly. Acute kidney failure occurs when the kidneys suddenly stop working and fail to filter wastes, causing electrolytes such as potassium to fall out of balance. Because acute kidney failure can occur in a matter of days or hours, it usually requires hospitalization or occurs while someone is already critically ill and hospitalized.
High potassium levels in the blood can signify dehydration. When the body is not properly hydrated, it cannot remove potassium efficiently, and the electrolyte begins to build up in the blood. Other, outward signs often make dehydration a straightforward diagnosis. People with excessive dehydration exhibit wrinkled skin, dry mouth, and general malaise. Bloodwork can confirm the diagnosis.
Internal bleeding can cause high potassium because ruptured blood cells often follow internal trauma. High potassium levels in a trauma victim can lead doctors to suspect internal bleeding. Trauma is not the only cause of internal bleeding; high potassium may also occur if someone is bleeding from an ulcer, which can cause the same ruptured blood cells.
Type 1 diabetes is a chronic disease caused by the body's inability to make insulin. If diet and insulin medications are not balanced, the condition can lead to kidney issues and high potassium levels in the blood. Improving or beginning treatment of type 1 diabetes will usually help correct a potassium imbalance, but high potassium can serve as an indication that the treatment plan needs adjustment.
Addison's disease occurs when damage to the adrenal cortex prevents glands from producing enough of the hormones aldosterone and cortisol. Aldosterone is responsible for regulating sodium and potassium in the body, so insufficient amounts of the hormone can make potassium levels in the blood increase rapidly. Medical treatment of Addison's disease will resolve potassium issues.
High potassium can develop in people taking medications such as chemotherapy drugs, ACE inhibitors, and angiotensin II receptor blockers that treat high blood pressure, chronic kidney disease, and heart failure. Prescriptions of this type often require individuals to undergo regular bloodwork to ensure the continued balance of electrolytes and that the kidneys are functioning normally.
Over time, alcohol and drug abuse can cause the muscles to break down and deteriorate. As this happens, muscle cells release potassium into the bloodstream, increasing levels and leading to hyperkalemia. Excessive alcohol intake can also lead to other electrolyte imbalances.
Doctors will treat high levels of potassium in various ways, often depending on the severity and cause of the issue. Emergency treatments may involve calcium IVs to treat the effects of excess potassium on the heart muscle, or kidney dialysis if acute or chronic kidney issues are to blame. For less serious cases, changes in diet such as avoiding foods high in the electrolyte can reduce levels.
Sometimes, lab reports that show high blood potassium are inaccurate. If blood cells rupture while the technician is taking the blood sample or after he or she has obtained it, potassium can leak into the sample and cause a high reading. People with no other symptoms of high potassium should take a second blood test to ensure they are not treated for hyperkalemia if they do not have it.
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