Hyperkalemia laboratory findings: Difference between revisions
Jump to navigation
Jump to search
No edit summary |
|||
| Line 2: | Line 2: | ||
{| class="infobox" style="float:right;" | {| class="infobox" style="float:right;" | ||
|- | |- | ||
| | | [[Image:Siren.gif|link=hyperkalemia resident survival guide|41x41px]]|| <br> || <br> | ||
| [[Hyperkalemia resident survival guide|Resident <br> Survival <br> Guide]] | | [[Hyperkalemia resident survival guide|Resident <br> Survival <br> Guide]] | ||
|} | |} | ||
{{Hyperkalemia}} | {{Hyperkalemia}} | ||
{{CMG}}; | {{CMG}}; {{AE}} [[Priyamvada Singh|Priyamvada Singh, M.B.B.S.]] [mailto:psingh13579@gmail.com], {{ADG}} | ||
==Overview== | ==Overview== | ||
In a patient who does not have a risk for hyperkalemia, repeating the blood test is indicated before taking any actions unless changes are present on [[electrocardiography]] | In a patient who does not have a risk for hyperkalemia, repeating the blood test is indicated before taking any actions unless changes are present on [[electrocardiography]] | ||
Latest revision as of 19:38, 30 July 2018
 |
Resident Survival Guide |
|
Hyperkalemia Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Hyperkalemia laboratory findings On the Web |
|
American Roentgen Ray Society Images of Hyperkalemia laboratory findings |
|
Risk calculators and risk factors for Hyperkalemia laboratory findings |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Priyamvada Singh, M.B.B.S. [2], Aditya Ganti M.B.B.S. [3]
Overview
In a patient who does not have a risk for hyperkalemia, repeating the blood test is indicated before taking any actions unless changes are present on electrocardiography
Laboratory Findings
- The first step in diagnosing hyperkalemia is to exclude pseudohyperkalemia by repeating the blood test.[1]
| Grade | Potassium level |
|---|---|
| Mild | 5-6.0mEq/L |
| Moderate | 6.1-7.2mEq/L |
| Severe | >7.2mEq/L |
Initial tests
- Complete blood count (CBC)[2]
- Metabolic profile .[3]
- Urine potassium, sodium, and osmolality [4]
| Hyperkalemia | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Exclude psuedohyperkalemia by repeating the blood test | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Acute rise in potassium | Persistent hyperkalemia | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Increase release of K+ from cells Trauma,radiation therapy, DKA, metabolic acidosis | Decreased urinary excreation of K+ rule out aldosterone deficency 24 hr urine K+ excreation | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Cause specific
- Blood glucose In patients with history of diabetes mellitus
- Digoxin level
- Arterial or venous blood gas (acidosis)
- Urinalysis (renal insufficiency)
- Serum cortisol and aldosterone levels (mineralocorticoid deficiency)
- Serum uric acid and phosphorus assays (tumor lysis syndrome)
- Serum creatinine phosphokinase (CPK) and calcium measurements and urine myoglobin test (crush injury or rhabdomyolysis)
Psudeohyperkalemia
- Defined as the release of potassium from cells after their breakdown. Most commonly seen during blood collection, so it's required to repeat blood test in patients with a transient rise in potassium without any risk factors.
- Other causes include
- Clotting increases release of potassium from platelets
- In patients with the history of leukemia where the WBC count is >120,000/microL the potassium is raised to cell fragility
- Hereditary (familial) forms of pseudohyperkalemia
References
- ↑ Lehnhardt A, Kemper MJ (2011). "Pathogenesis, diagnosis and management of hyperkalemia". Pediatr Nephrol. 26 (3): 377–84. doi:10.1007/s00467-010-1699-3. PMC 3061004. PMID 21181208.
- ↑ Ingelfinger JR (2015). "A new era for the treatment of hyperkalemia?". N Engl J Med. 372 (3): 275–7. doi:10.1056/NEJMe1414112. PMID 25415806.
- ↑ Kogika MM, de Morais HA (2017). "A Quick Reference on Hyperkalemia". Vet. Clin. North Am. Small Anim. Pract. 47 (2): 223–228. doi:10.1016/j.cvsm.2016.10.009. PMID 27939860.
- ↑ Conte G, Dal Canton A, Imperatore P, De Nicola L, Gigliotti G, Pisanti N; et al. (1990). "Acute increase in plasma osmolality as a cause of hyperkalemia in patients with renal failure". Kidney Int. 38 (2): 301–7. PMID 2402122.