Signs and treatment of hyperkalemia: ask an expert

Hyperkalemia refers to high potassium levels in the blood. Symptoms are rare in the first phases, but they may include weakness, fatigue, and heart arrhythmias. Prompt medical care is

essential. High levels of potassium in the blood may lead to health complications and unpleasant symptoms. How to flush excess potassium from your body depends on the causes and your overall

health. Early intervention can make a difference. 1. What are the most common causes of hyperkalemia? Hyperkalemia occurs when the potassium levels in your blood are greater than 5.5 mEq/L.

Causes of hyperkalemia may include : * taking in too much potassium as a medication, supplement, or high-potassium foods * potassium shifts due to blood loss or dehydration * not being able

to excrete potassium through your kidneys properly due to kidney disease Certain medications may cause elevated potassium levels as well. This is usually in the setting of someone with

acute or chronic kidney disease. False elevations of potassium are commonly seen in lab results. This is known as pseudohyperkalemia. When someone has an elevated potassium reading, a

medical professional will want to do a second test to make sure the results hold. 2. What treatments are available for hyperkalemia? First, your healthcare professional will make sure that

the hyperkalemia hasn’t caused any changes to your heart by performing an electrocardiogram (EKC). If you develop an unstable heart rhythm due to elevated potassium levels, then your

healthcare team may start calcium therapy to stabilize your heart rhythm. If no changes to your heart are present, your medical professional may start you on insulin therapy followed by a

glucose infusion. These steps help to bring down the blood potassium levels quickly. It’s also possible that they use dialysis if you require urgent treatment, particularly if you have

kidney disease. Following this, you may need medication to remove the potassium left in your body. Options may include a loop or thiazide diuretic, or a cation exchanger or potassium binder

medication. The cation exchangers available are patiromer (Veltassa) or sodium zirconium cyclosilicate (Lokelma). 3. What are the warning signs of hyperkalemia? Hyperkalemia rarely causes

warning signs. People with mild or even moderate hyperkalemia may not see or feel any different. If someone does have a high enough change in their potassium levels, they may experience: *

muscle weakness * fatigue * nausea If an EKG is performed, an irregular heartbeat, also known as an arrhythmia, may become evident. 4. How do you know if you have severe hyperkalemia? If you

have severe hyperkalemia, symptoms may include: * severe muscle weakness * muscle paralysis * decreased tendon reflexes You may also experience symptoms of an irregular heartbeat: *

dizziness or lightheadedness * heart palpitations * chest pain * sweating without evident cause * fatigue * pale skin * difficulty breathing * fainting If your hyperkalemia causes cardiac

changes, your healthcare team may prioritize treatment to avoid cardiac arrest. 5. What should you include in your diet to help lower potassium? If you have hyperkalemia, doctors will advise

you to avoid certain foods that are high in potassium. You may also need to increase your fluid intake. Dehydration can make hyperkalemia worse. No specific foods will lower your potassium

level, but some foods contain lower levels of potassium. For example, apples, berries, cauliflower, rice, and pasta are all low-potassium foods. Still, it’s important to limit your portion

sizes when eating these foods. 6. What foods should you avoid? You may want to avoid fruits that are high in potassium, like: * bananas * kiwis * mangoes * cantaloupe * oranges * avocados

Vegetables that are high in potassium include: * spinach * tomatoes * potatoes * broccoli * beets * carrots * squash * lima beans Other foods that are high in potassium include: * dried

fruits * seaweed * nuts * red meats Your doctor can provide you with a full list of high-potassium foods. 7. What are the risks of untreated hyperkalemia? Hyperkalemia that isn’t properly

treated may result in serious cardiac arrhythmia. This, in turn, may lead to cardiac arrest and, in some cases, death. If your doctor tells you that your lab results indicate hyperkalemia,

you should receive medical attention right away. Your healthcare team will check your potassium levels again to rule out pseudohyperkalemia (false positive results). But if you do have

hyperkalemia, they will proceed to bring your potassium levels down. 8. Are there any other lifestyle changes to prevent hyperkalemia? The occurrence of hyperkalemia within the general

population is low. Most people can eat foods that are rich in potassium or be on medications without their potassium levels increasing. People who are most at risk of hyperkalemia are those

with acute or chronic kidney disease. You can prevent kidney disease by leading a healthy lifestyle. This includes: * blood pressure management * exercising * tobacco use cessation *

limiting alcohol * weight management Other frequently asked questions HOW CAN YOU LOWER YOUR POTASSIUM LEVELS QUICKLY? If you have acute hyperkalemia, prompt medical attention is necessary

to avoid damage to your heart and kidneys. To lower your potassium levels quickly, your healthcare team may use dialysis and other medications to excrete potassium from your body. WHAT

FLUSHES POTASSIUM OUT OF YOUR SYSTEM? A healthcare professional may use diuretics and potassium binders to flush potassium out of your body if you have hyperkalemia. Intravenous insulin and

glucose may help lower potassium levels. Drinking more fluids, including water, also helps, but you need medical guidance to prevent another electrolyte disorder. WHAT CAN YOU DRINK TO BRING

YOUR POTASSIUM DOWN? Pineapple juice, grape juice, apple juice, cranberry juice, watermelon juice, rice milk, and sparkling water may help bring and keep potassium levels down. The takeaway

Hyperkalemia refers to high potassium levels in the blood. It typically requires prompt medical attention to prevent heart and kidney complications. Hyperkalemia rarely shows early symptoms

but may cause heart palpitations, dizziness, fatigue, and muscle weakness in more severe cases. Treatment of acute hyperkalemia may include dialysis, intravenous insulin and glucose,

diuretics, and potassium-binding medications. Avoiding foods with high potassium and increasing fluid intake is recommended. Medical guidance is essential in recovering from high potassium

disorders. ------------------------- Alana Biggers, MD, MPH, FACP, is an internist and an assistant professor of medicine at the University of Illinois-Chicago (UIC) College of Medicine,

where she received her MD degree. She also has a Master of Public Health in chronic disease epidemiology from Tulane University School of Public Health and Tropical Medicine and completed a

public health fellowship at the Centers for Disease Control and Prevention (CDC). Dr. Biggers has interests in health disparity research and currently has a NIH grant for research in

diabetes mellitus and sleep.