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Hyperkalemia

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  1. Causes
    1. See Hyperkalemia Causes
  2. Signs and Symptoms
    1. Symptoms occur when Serum Potassium > 6.0 to 6.5 meq/L
    2. Neurologic Changes
      1. Weakness
      2. Paresthesias
      3. Areflexia
      4. Ascending paralysis
      5. Respiratory failure
    3. Cardiovascular Changes
      1. Bradycardia to Asystole or Ventricular Fibrillation
      2. AV prolonged transmission to complete Heart Block
  3. Labs
    1. Chemistry Panel
      1. Serum Potassium
      2. Serum electrolytes including serum bicarbonate
      3. Renal Function tests (BUN, Creatinine)
    2. Spot urine for Urine Potassium and Urine Creatinine
      1. Fractional Excretion of Potassium
      2. Transtubular Potassium Gradient
  4. Diagnostics: Electrocardiogram
    1. Changes occur when Serum Potassium >6.0 meq/L
    2. Initial
      1. T Waves peaked or Tented
    3. Next
      1. ST depression
      2. First degree AV Block or loss of P Wave
      3. QRS widening
    4. Final
      1. Biphasic wave (sine wave) QRS and T fusion
      2. Imminent ventricular standstill
    5. Changes exacerbated by:
      1. Hyponatremia
      2. Hypocalcemia
      3. Metabolic Acidosis
      4. Hypermagnesemia
  5. Management
    1. See Hyperkalemia Management
  6. References
    1. Gibbs in Marx (2002) Rosen's Emerg Med, p. 1730-1
    2. Klahr (2001) in Noble (2001) Primary Care p. 1359-62

hyperkalemia (C0020461)

Definition (MSH)Abnormally high potassium concentration in the blood, most often due to defective renal excretion. It is characterized clinically by electrocardiographic abnormalities (elevated T waves and depressed P waves, and eventually by atrial asystole). In severe cases, weakness and flaccid paralysis may occur. (Dorland, 27th ed)
Definition (CSP)abnormally high potassium concentration in the blood, most often due to defective renal excretion; characterized clinically by electrocardiographic abnormalities; in severe cases, weakness and flaccid paralysis may occur.
Definition (NCI)Hyperkalemia; higher than normal levels of potassium in the circulating blood; associated with kidney failure or sometimes with the use of diuretic drugs.
ConceptsFinding (T033)
ICD9276.7, 276.7
MSHD006947
Englishexcess potassium, high blood potassium level, HYPERKALAEMIA, Hyperkalaemic syndrome, hyperkalemia, Hyperkalemias, Hyperkalemic syndrome, Hyperpotassaemia, HYPERPOTASSEMIA, Hyperpotassemias, K excess, K overload, Potassium excess, Potassium overload
Spanishexceso de K, exceso de potasio, hipercalemia, hipercaliemia, hiperkalemia, hiperpotasemia, sindrome hiperpotasemico, sobrecarga de potasio
Parent ConceptsDisorder of fluid AND/OR electrolyte (C0267994), Electrolyte Balance (C0013831), Potassium disorder (C0268014), POTASSIUM ABNORMALITY (C0549635), Water-Electrolyte Imbalance (C0043065), Abnormal Blood Chemistry and Hematology Test Result (C1332129), Mineral excess (C0342946), Duplicate concept (C1274013)
SourcesAOD, CCS, COSTAR, CSP, CST, DXP, ICD9CM, MSH, MTH, MTHICD9, NCI, NDFRT, OMIM, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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