Medical Intelligence from The New England Journal of Medicine — VI. Hyperkalemia. Hyperkalemia is a potentially life-threatening condition in which serum potassium exceeds mmol/l. It can be caused by reduced renal excretion, excessive. n engl j med ;3 january 15, mmol per liter.1,2 Hyperkalemia is defined as erate hyperkalemia) and more than mmol per.

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Pseudohyperkalemia If elevated serum potassium is found in an asymptomatic patient with no apparent cause, factitious hyperkalemia should be considered. Reduction in adrenal aldosterone biosynthesis through interrupting renin-aldosterone axis.

Acute increase in osmolality secondary to hyperglycemia or mannitol infusion causes potassium to exit from cells [ 24 ]. Diagnosis of hyperkalemia Hyperkalemia can be classified according to serum potassium into mild 5.

Am J Emerg Med. Martyn JA, Richtsfeld M.

Management should not only rely on ECG changes but be guided by the clinical scenario and serial potassium measurements [ 2931 ]. Diarrhea if preparations come premixed with sorbitol.


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Pathogenesis, diagnosis and management of hyperkalemia

Especially when capillary samples are taken, excess alcohol on the skin should be avoided, as it is the primary cause of the hemolysis in this process.

Nem and gastrointestinal potassium excretion in humans: It can be caused by reduced renal excretion, excessive intake or leakage of potassium from the intracellular space.

Sustained-release potassium chloride overdose. Mechanisms in hyperkalemic renal tubular acidosis.

Succinylcholine, especially when given to patients with burn injuries, immobilization, or inflammation [ 26 ]. Test is most useful in distinguishing patients who have mineralocorticoid deficiency versus resistance by observing a change in TTKG values after administration of mineralocorticoid: Transient type 1 pseudo-hypoaldosteronism: National Center for Biotechnology InformationU. Low extracellular potassium concentrations of 3.

Hyperkalemia is rarely associated with symptoms, occasionally patients complain of palpitations, nausea, muscle pain, or paresthesia. Acid-base balance can affect the balance between cellular and extracellular potassium concentration. Excretion mainly occurs in the cortical collecting duct [ 2 ]. Used with permission from [ 40 ] RTA renal tubular acidosis.

Pathogenesis, diagnosis and management of hyperkalemia

Clin J Am Soc Nephrol. Mineral acidosis is more likely to cause a shift of potassium from intracellular space into extracellular space than organic acidosis.


Especially in pediatrics, mechanical hemolysis can occur during difficult blood draws, and even more in samples with lymphocytosis or thrombocytosis. Non-steroidal anti-inflammatory drugs NSAIDs; ibuprofen, naproxen hyperkalemoa ACEI angiotensin converting enzyme inhibitors as well as angiotensin receptor inhibitors can cause a decrease in aldosterone and GFR and thereby lead to hyperkalemia [ 13 ]. J Am Coll Nutr.

Oxford University Press, p Close electrolyte and blood glucose monitoring is needed, hypoglycemia being the main side-effect. Hyperkalemia may result from an increase in total body potassium secondary to imbalance of intake vs.

Published online Dec Human cortical distal nephron: Support Center Support Center.

Succinylcholine-induced hyperkalemia in acquired pathologic states: Curr Opin Nephrol Hypertens. Sodium bicarbonate, preferably given to patients who are acidotic. Enemas should be retained at least min.