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It is possible that the main title of the report Hyperkalemia is not the name you expected. Please check the synonyms listing to find the alternate name(s) and disorder subdivision(s) covered by this report.
Related Disorders List
Information on the following diseases can be found in the Related Disorders section of this report:
- Addison's Disease
- ACTH Deficiency
- Purpura, Thrombotic Thrombocytopenic
Hyperkalemia is a condition caused by an abnormally high concentration of potassium in the blood. Potassium is a key element in contraction of muscles (including the heart) and for the functioning of many complicated proteins (enzymes). Potassium is found primarily in the skeletal muscle and bone, and participates with sodium to contribute to the normal flow between the body fluids and the cells of the body (homeostasis). The concentration of potassium in the body is regulated by the kidneys, and balance is maintained through excretion in urine. When the kidneys are functioning normally, the amount of potassium in the diet is usually sufficient for use by the body and the excess is excreted. Chemical and hormonal influences also help regulate the internal potassium balance. When hyperkalemia occurs, there is an imbalance resulting from a dysfunction of these normal processes.
Normally, 98% of the potassium in the body is found in the cells of various tissues, while only about 2% is circulating in the blood. When hyperkalemia occurs, it may come about because of an increase in total body potassium or as a result of increased release of potassium from the cells to the blood.
Abnormally high levels of potassium in the blood or urine suggest the presence of another underlying medical condition. Because potassium helps to regulate muscle activity, including the activity of heart (cardiac) muscle, hyperkalemia needs to be taken seriously.
Some individuals with hyperkalemia may not have symptoms (asymptomatic). Occasionally, symptoms may include nausea, irregular heartbeat and/or slow and weak pulse. The latter two of these signs indicate a potential emergency. Blood potassium may be high and the pulse may be weak.
Because hyperkalemia affects the heart, examination by electrocardiography (ECG) is essential. An ECG may pick up abnormalities of the heartbeat including several potentially life-threatening conditions, such as slower-than-normal rhythms (bradycardia), partial-to-complete heart blocks, and an uncontrolled rapid heart beat (fibrillation). A type of paralysis in which muscle tone is lacking in the extremities (flaccid paralysis) may be present. Individuals with hyperkalemia may experience a loss of deep tendon reflexes, and difficulties in speaking (phonation) and breathing.
Hyperkalemia is a symptom of some other underlying medical condition. Diseases and disorders that reduce the kidney's ability to excrete potassium are often the causes of the excess potassium. Such disorders include inflammatory disease of the kidneys (acute tubular nephrosis); acute or chronic kidney failure, excessive acid production (metabolic or diabetic acidosis), or a deficiency of the hormone aldosterone (Addison's disease). Other causes may include multiple transfusions of stored blood, internal acid-base disturbances, sickle-cell anemia, excess sugar in the blood (hyperglycemia), and excessive dietary intake of potassium. The use of drugs that act in opposition to the hormone aldosterone (aldosterone antagonists), muscle relaxant succinylcholine, extensive burns, crushing injuries that cause bleeding into surrounding soft tissue (e.g., fatty tissue) or conditions causing bleeding in the gastrointestinal tract may also cause hyperkalemia.
Males are more prone to hyperkalemia than are women. It is also more likely to occur among the very aged and the very young than among those at mid-life. Individuals with kidney malfunction associated with diabetes (diabetic nephropathy or interstitial renal disease), an abnormally low level of the enzyme renin (hyporeninemia), or abnormally low levels of the hormone aldosterone (hypoaldosteronism), may increase the risk for hyperkalemia.
Symptoms of the following disorders may include Hyperkalemia. Comparisons may be useful for a differential diagnosis:
Addison's Disease is a disorder characterized by chronic and insufficient functioning of the outer layer of the adrenal gland (adrenal cortex). This malfunction results in a deficiency of the hormone aldosterone. Individuals with this disorder show abnormally high concentrations of potassium (hyperkalemia) and abnormally low concentrations of sodium in the blood. Symptoms may include weakness, low blood pressure and loss of appetite. (For more information on this disorder, choose "Addison" as your search term in the Rare Disease Database.)
ACTH Deficiency is a disorder characterized by low levels or absence of the hormone ACTH which is manufactured by the pituitary gland. Symptoms of ACTH Deficiency may include weakness, nausea, vomiting, low blood pressure, abnormally high concentrations of potassium in the blood (hyperkalemia) and lack of appetite. (For more information on this disorder, choose "ACTH Deficiency" as your search term in the Rare Disease Database.)
Thrombotic Thrombocytopenic Purpura (TTP) is a serious blood disorder characterized by a decrease in blood platelets, abnormal destruction of red blood cells and disturbances in the nervous system. Symptoms may include fever, fatigue, patches of purplish discoloration in the skin (purpura), weakness, kidney dysfunction and abnormally high levels of potassium in the blood (hyperkalemia). (For more information on this disorder, choose "TTP" as your search term in the Rare Disease Database.)
(To locate other disorders that include Hyperkalemia as a symptom, choose "Hyperkalemia" as your search term in the Rare Disease Database.)
Indications of hyperkalemia include a slow pulse in combination with high levels of potassium in the blood and particular patterns of ECG changes.
Treatment of acute hyperkalemia may require intravenous calcium as a temporary measure . Since such treatment lasts for only about an hour, other measures are required. Depending upon the cause of hyperkalemia, glucose and insulin may be administered intravenously. Diuretics or sodium polystyrene may be administered to increase the body's excretion of potassium. Dialysis may also be required but only after more conservative treatments have failed.
Periodic paralysis may be treated with the drug albuterol. Calcium gluconate may be administered to reverse certain heart abnormalities. If no ECG abnormalities are present, the drug sorbitrol may be prescribed. Other treatment is symptomatic and supportive.
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Baz EM, Kanazi GE, Mahfouz RA, et al. An unusual case of hyperkalaemic-induced cardiac arrest in a paediatric patient during transfusion of a "fresh" 6-day-old blood unit. Transfus Med. 2002;12:383-86.
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FROM THE INTERNET
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