Advertisement

Disorders of Potassium: Hyperkalemia

  • Alluru S. ReddiEmail author
Chapter

Abstract

Hyperkalemia is defined as a serum [K+] > 5.5 mEq/L. It is common in both outside and in-hospital patients. Hyperkalemia can be fatal if not recognized and treated. Proper treatment of hyperkalemia depends on the underlying cause. True hyperkalemia is caused by an excessive exogenous load of K+; it can also result from a decrease in cellular uptake, massive release following cell lysis, or a decrease in renal excretion. A number of drugs also cause hyperkalemia. Pseudohyperkalemia refers to a condition in which K+ is released from cells during venipuncture following prolonged application of a tourniquet in the arm. Hemolysis of red blood cells and an increased number of white blood cells (> 100,000 cells) and platelets (> 1,000,000 platelets) also release K+ and cause pseudohyperkalemia. A benign form of familial pseudohyperkalemia due to leakage of K+ from blood cells has been described in some families.

Keywords

Hyperkalemia Pseudohyperkalemia Hyperkalemic periodic paralysis Chronic kidney disease Addison disease Adrenal hyperplasia Pseudohypoaldosteronism 

Suggested Reading

  1. 1.
    Mount DB, Zandi-Nejad K. Disorders of potassium balance. In: Taal M, Chertow GM, Marsden PA, editors. Brenner & Rector’s the kidney. 9th ed. Philadelphia: Saunders; 2012. pp. 640–88.CrossRefGoogle Scholar
  2. 2.
    Nyirenda M, Tang JI, Padfield PL, et al. Hyperkalemia. BMJ. 2009;339:1019–24.CrossRefGoogle Scholar
  3. 3.
    Palmer BF. A physiologic-based approach to the evaluation of a patient with hyperkalemia. Am J Kidney Dis. 2010;56:387–93.PubMedCrossRefGoogle Scholar
  4. 4.
    Segal A. Potassium and dyskalemias. In: Mount DB, Sayegh MH, Singh AJ, editors. Core concepts in the disorders of fluid, electrolytes and acid-base balance. New York: Springer; 2013. pp. 49–102.CrossRefGoogle Scholar
  5. 5.
    Shingarev R, Allon M. A physiologic-based approach to the treatment of acute hyperkalemia. Am J Kidney Dis. 2010;56:578–84.PubMedCrossRefGoogle Scholar
  6. 6.
    Weisberg LS. Management of severe hyperkalemia. Crit Care Med. 2008;36:3246–51.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Department of Medicine Division of Nephrology and HypertensionRutgers New Jersey Medical SchoolNewarkUSA

Personalised recommendations