High potassium (hyperkalemia)

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Definition

Hyperkalemia is the medical term that describes a potassium level in your blood that’s higher than normal. Potassium is a nutrient that is critical to the function of nerve and muscle cells, including those in your heart.

Your blood potassium level is normally 3.6 to 5.2 millimoles per liter (mmol/L). Having a blood potassium level higher than 7.0 mmol/L can be dangerous and requires immediate treatment.

Causes

Often, a report of high blood potassium isn’t true hyperkalemia. Instead, it may be caused by the rupture of blood cells in the blood sample during or shortly after the blood draw. The ruptured cells leak their potassium into the sample. This falsely raises the amount of potassium in the blood sample, even though the potassium level in your body is actually normal. When this is suspected, a repeat blood sample is done.

The most common cause of genuinely high potassium (hyperkalemia) is related to your kidneys, such as:

  • Acute kidney failure
  • Chronic kidney disease

Other causes of hyperkalemia include:

  • Addison’s disease (adrenal failure)
  • Alcoholism or heavy drug use that causes rhabdomyolysis, a breakdown of muscle fibers that results in the release of potassium into the bloodstream
  • Angiotensin-converting enzyme (ACE) inhibitors
  • Angiotensin II receptor blockers (ARBs)
  • Destruction of red blood cells due to severe injury or burns
  • Excessive use of potassium supplements
  • Type 1 diabetes

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