Hyperkalemia causes: Difference between revisions
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| [[File:Siren.gif | | <figure-inline>[[File:Siren.gif|link=hyperkalemia resident survival guide|41x41px]]</figure-inline>|| <br> || <br> | ||
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==Overview== | ==Overview== | ||
[[Hyperkalemia]] is an elevated [[blood]] level (above 5. | [[Hyperkalemia]] is an elevated [[blood]] level (above 5.1 mmol/L) of the [[electrolyte]] [[potassium]]. ". Extreme degrees of [[hyperkalemia]] are considered a [[medical emergency]] due to the risk of potentially fatal [[arrhythmia]]s. Hyperkalemia can be caused by reasons that include increased uptake, [[extracellular]] shift, tissue breakdown and impaired excretion from the [[body]]. | ||
==Causes== | ==Causes== | ||
===Life Threatening Causes=== | ===Life Threatening Causes=== | ||
Hyperkalemia | *Hyperkalemia can become a life-threatening condition if potassium levels are too high and body is not able to remove it effectively. | ||
*[[Acute kidney injury|AKI]] and [[chronic renal failure]]<ref name="pmid11095656">{{cite journal| author=De Nicola L, Bellizzi V, Minutolo R, Cioffi M, Giannattasio P, Terracciano V et al.| title=Effect of dialysate sodium concentration on interdialytic increase of potassium. | journal=J Am Soc Nephrol | year= 2000 | volume= 11 | issue= 12 | pages= 2337-43 | pmid=11095656 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11095656 }} </ref> | |||
*[[Addisonian crisis]] | |||
*[[Diabetic ketoacidosis]] | |||
*Intravenous [[potassium]] supplement | |||
*[[Digoxin]] toxicity | |||
*[[Tumor lysis syndrome]] | |||
===Common Causes=== | ===Common Causes=== | ||
The most common causes of hyperkalemia include:<ref name="pmid18839206">{{cite journal| author=Wang WH, Giebisch G| title=Regulation of potassium (K) handling in the renal collecting duct. | journal=Pflugers Arch | year= 2009 | volume= 458 | issue= 1 | pages= 157-68 | pmid=18839206 | doi=10.1007/s00424-008-0593-3 | pmc=2730119 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18839206 }} </ref><ref name="pmid21170894">{{cite journal| author=Giebisch GH, Wang WH| title=Potassium transport--an update. | journal=J Nephrol | year= 2010 | volume= 23 Suppl 16 | issue= | pages= S97-104 | pmid=21170894 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21170894 }} </ref> | |||
* [[ACE inhibitors]] | * [[ACE inhibitors]] | ||
* [[Acidosis]] | * [[Acidosis]] | ||
Line 26: | Line 33: | ||
* [[Malnutrition]] | * [[Malnutrition]] | ||
* [[Renal tubular acidosis]] | * [[Renal tubular acidosis]] | ||
* [[ | |||
=== Less common causes === | |||
* Fasting | |||
*[[Exercise]] | |||
*[[Fluoride]] toxicity | |||
*[[Hypoparathyroidism]] | |||
=== Genetic causes === | |||
*[[Congenital adrenal hyperplasia|Congenital adrenal hypoplasia]] | |||
* Hyperkalemic periodic paralysis | |||
*[[Pseudohypoaldosteronism]] type1 and type 2 | |||
===Causes by Organ System=== | ===Causes by Organ System=== | ||
{|style="width:80%; height:100px" border="1" | {| style="width:80%; height:100px" border="1" | ||
| | | style="width:25%" bgcolor="LightSteelBlue" ; border="1" | '''Cardiovascular''' | ||
| | | style="width:75%" bgcolor="Beige" ; border="1" | [[Heart failure]], [[volume depletion]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Chemical / poisoning''' | | '''Chemical / poisoning''' | ||
|bgcolor="Beige"| [[Ammonium Bifluoride]], [[arsenicals]], [[fluoride]] toxicity, [[foxglove]] [[poisoning]], [[oleander]] [[poisoning]], [[tungsten]], white chameleon [[poisoning]] | | bgcolor="Beige" | [[Ammonium Bifluoride]], [[arsenicals]], [[fluoride]] toxicity, [[foxglove]] [[poisoning]], [[oleander]] [[poisoning]], [[tungsten]], white chameleon [[poisoning]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Dermatologic''' | | '''Dermatologic''' | ||
|bgcolor="Beige"| No underlying causes | | bgcolor="Beige" | No underlying causes | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Drug Side Effect''' | | '''Drug Side Effect''' | ||
|bgcolor="Beige"| [[ACE inhibitors]], [[Acetaminophen and Oxycodone]], [[acetylsalicylic Acid]], [[aldosterone antagonists]], [[amiloride]], [[Amlodipine besylate and Valsartan]], [[angiotensin receptor blockers]], [[beta blockers]], [[Cefepime]], [[Cefpodoxime]], [[celecoxib]], [[Cidofovir]], [[cyclosporine]], [[diazoxide]], [[digoxin]], [[Drospirenone and Ethinyl estradiol]], [[eplerenone]], epsilon amino caproic acid, (EACA), [[erythropoietin]], [[heparin]], [[ibuprofen]], [[indomethacin]], [[isoflurane]], [[ketoprofen]], [[low-molecular weight heparin]], [[Lisinopril and Hydrochlorothiazide]], [[mannitol]], [[melarsoprol]], [[methotrexate]], [[minoxidil]], [[naproxen]], [[Nilotinib]], [[pancuronium bromide]], [[pimecrolimus]], [[potassium chloride]], [[potassium citrate]], [[pomalidomide]],[[propofol infusion syndrome]], [[rifaximin]], [[sodium thiopental]], [[somatostatin]] therapy, [[spironolactone]], [[succinylcholine]], [[sulindac]], [[suxamethonium]], [[tacrolimus]], [[thalidomide]], [[triamterene]], [[trimethoprim]] | | bgcolor="Beige" | [[ACE inhibitors]], [[Acetaminophen and Oxycodone]], [[acetylsalicylic Acid]], [[aldosterone antagonists]], [[amiloride]], [[Amlodipine besylate and Valsartan]], [[angiotensin receptor blockers]], [[Basiliximab]], [[beta blockers]], [[Cefepime]], [[Cefpodoxime]], [[celecoxib]], [[Cidofovir]], [[cyclosporine]], [[diazoxide]], [[digoxin]], [[Drospirenone and Ethinyl estradiol]], [[eplerenone]], epsilon amino caproic acid, (EACA), [[erythropoietin]], [[heparin]], [[ibuprofen]], [[indomethacin]], [[isoflurane]], [[ketoprofen]], [[low-molecular weight heparin]], [[Lisinopril and Hydrochlorothiazide]], [[mannitol]], [[melarsoprol]], [[methotrexate]], [[minoxidil]], [[naproxen]], [[Nivolumab]], [[Nilotinib]], [[pancuronium bromide]], [[pimecrolimus]], [[potassium chloride]], [[Potassium bicarbonate]], [[potassium citrate]], [[pomalidomide]],[[propofol infusion syndrome]], [[rifaximin]], [[sodium thiopental]], [[somatostatin]] therapy, [[spironolactone]], [[succinylcholine]], [[sulindac]], [[suxamethonium]], [[tacrolimus]], [[thalidomide]], [[triamterene]], [[trimethoprim]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Ear Nose Throat''' | | '''Ear Nose Throat''' | ||
|bgcolor="Beige"| No underlying causes | | bgcolor="Beige" | No underlying causes | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Endocrine''' | | '''Endocrine''' | ||
|bgcolor="Beige"| [[ACTH Deficiency]], [[addisonian crisis]], [[addison's disease]], [[adrenal gland disorders]], [[adrenal hyperplasia, congenital type 3]], [[autoimmune adrenalitis]], [[congenital adrenal hyperplasia]] -- sodium-wasting form, [[diabetes]], [[diabetic ketoacidosis]], [[hyperglycemia]], hypoadrenocorticism -- [[hypoparathyroidism]] -- [[moniliasis]], [[hyporeninemic hypoaldosteronism]], isolated aldosterone synthase deficiency, [[lipoid congenital adrenal hyperplasia]], [[pseudohypoaldosteronism]] type 1, [[pseudohypoaldosteronism]] type 2 | | bgcolor="Beige" | [[ACTH Deficiency]], [[addisonian crisis]], [[addison's disease]], [[adrenal gland disorders]], [[adrenal hyperplasia, congenital type 3]], [[autoimmune adrenalitis]], [[congenital adrenal hyperplasia]] -- sodium-wasting form, [[diabetes]], [[diabetic ketoacidosis]], [[hyperglycemia]], hypoadrenocorticism -- [[hypoparathyroidism]] -- [[moniliasis]], [[hyporeninemic hypoaldosteronism]], isolated aldosterone synthase deficiency, [[lipoid congenital adrenal hyperplasia]], [[pseudohypoaldosteronism]] type 1, [[pseudohypoaldosteronism]] type 2 | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Environmental''' | | '''Environmental''' | ||
|bgcolor="Beige"| No underlying causes | | bgcolor="Beige" | No underlying causes | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Gastroenterologic''' | | '''Gastroenterologic''' | ||
|bgcolor="Beige"| [[Cirrhosis]], [[gastrointestinal bleeding]] | | bgcolor="Beige" | [[Cirrhosis]], [[gastrointestinal bleeding]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Genetic''' | | '''Genetic''' | ||
|bgcolor="Beige"| [[18-Hydroxylase deficiency]], [[congenital adrenal hyperplasia]] type 3, [[congenital adrenal hyperplasia]] -- sodium-wasting form, isolated aldosterone synthase deficiency, [[lipoid congenital adrenal hyperplasia]], [[pseudohypoaldosteronism]] type 1, [[pseudohypoaldosteronism]] type 2 | | bgcolor="Beige" | [[18-Hydroxylase deficiency]], [[congenital adrenal hyperplasia]] type 3, [[congenital adrenal hyperplasia]] -- sodium-wasting form, isolated aldosterone synthase deficiency, [[lipoid congenital adrenal hyperplasia]], [[pseudohypoaldosteronism]] type 1, [[pseudohypoaldosteronism]] type 2 | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Hematologic''' | | '''Hematologic''' | ||
|bgcolor="Beige"| [[Hemolytic anemia]], [[leukaemia]], [[leukocytosis]], [[sickle cell disease]], [[thrombotic thrombocytopenic purpura]] | | bgcolor="Beige" | [[Hemolytic anemia]], [[leukaemia]], [[leukocytosis]], [[sickle cell disease]], [[thrombotic thrombocytopenic purpura]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Iatrogenic''' | | '''Iatrogenic''' | ||
|bgcolor="Beige"| [[blood transfusion ]], cuffed [[blood]] sample, delayed separation [[blood]] sample, drip arm sample, EDTA blood sample, hemolysed blood sample, IV fluids containing [[potassium]], using clenched fist while collection of blood | | bgcolor="Beige" | [[blood transfusion ]] , cuffed [[blood]] sample, delayed separation [[blood]] sample, drip arm sample, EDTA blood sample, hemolysed blood sample, IV fluids containing [[potassium]], using clenched fist while collection of blood | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Infectious Disease''' | | '''Infectious Disease''' | ||
|bgcolor="Beige"| [[HIV]] infection | | bgcolor="Beige" | [[HIV]] infection | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Musculoskeletal / Ortho''' | | '''Musculoskeletal / Ortho''' | ||
|bgcolor="Beige"| Muscle damage, muscle wasting | | bgcolor="Beige" | Muscle damage, muscle wasting | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Neurologic''' | | '''Neurologic''' | ||
|bgcolor="Beige"| [[Amelo-cerebro-hypohidrotic syndrome]], Kohlschutter-Tonz syndrome | | bgcolor="Beige" | [[Amelo-cerebro-hypohidrotic syndrome]], Kohlschutter-Tonz syndrome | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Nutritional / Metabolic''' | | '''Nutritional / Metabolic''' | ||
|bgcolor="Beige"| [[Arginine|hydrochloride Arginine]], high [[Potassium]] diet, [[Malnutrition]] | | bgcolor="Beige" | [[Arginine|hydrochloride Arginine]], high [[Potassium]] diet, [[Malnutrition]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Obstetric/Gynecologic''' | | '''Obstetric/Gynecologic''' | ||
|bgcolor="Beige"| No underlying causes | | bgcolor="Beige" | No underlying causes | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Oncologic''' | | '''Oncologic''' | ||
|bgcolor="Beige"| No underlying causes | | bgcolor="Beige" | No underlying causes | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Opthalmologic''' | | '''Opthalmologic''' | ||
|bgcolor="Beige"| No underlying causes | | bgcolor="Beige" | No underlying causes | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Overdose / Toxicity''' | | '''Overdose / Toxicity''' | ||
|bgcolor="Beige"| No underlying causes | | bgcolor="Beige" | No underlying causes | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Psychiatric''' | | '''Psychiatric''' | ||
|bgcolor="Beige"| No underlying causes | | bgcolor="Beige" | No underlying causes | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Pulmonary''' | | '''Pulmonary''' | ||
|bgcolor="Beige"| No underlying causes | | bgcolor="Beige" | No underlying causes | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Renal / Electrolyte''' | | '''Renal / Electrolyte''' | ||
|bgcolor="Beige"| [[Acidosis]], [[acute glomerulonephritis]], [[acute renal failure]], chronic [[interstitial nephritis]], [[chronic renal failure]], [[diabetic nephropathy]], distal [[chloride]] shunt, distal [[renal tubular acidosis]] type IV, Gordon's syndrome, [[hemolytic uremic syndrome]], [[hyperkalemic periodic paralysis]], hyperkalemic [[Renal tubular acidosis]], [[hypernatremia]], [[hyperosmolality]], [[hyperphosphataemia]], [[lupus nephritis]], [[obstructive uropathy]], [[polycystic kidney disease]], Familial [[pseudohyperkalemia]]-due to red cell leak, Distal [[renal tubular acidosis]] type 1, transplanted kidneys, [[tubulointerstitial disease]], [[urinary tract obstruction]], [[urolithiasis]], [[hyporeninemic hypoaldosteronism]], [[amyloidosis]] | | bgcolor="Beige" | [[Acidosis]], [[acute glomerulonephritis]], [[acute renal failure]], chronic [[interstitial nephritis]], [[chronic renal failure]], [[diabetic nephropathy]], distal [[chloride]] shunt, distal [[renal tubular acidosis]] type IV, Gordon's syndrome, [[hemolytic uremic syndrome]], [[hyperkalemic periodic paralysis]], hyperkalemic [[Renal tubular acidosis]], [[hypernatremia]], [[hyperosmolality]], [[hyperphosphataemia]], [[lupus nephritis]], [[obstructive uropathy]], [[polycystic kidney disease]], Familial [[pseudohyperkalemia]]-due to red cell leak, Distal [[renal tubular acidosis]] type 1, transplanted kidneys, [[tubulointerstitial disease]], [[urinary tract obstruction]], [[urolithiasis]], [[hyporeninemic hypoaldosteronism]], [[amyloidosis]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Rheum / Immune / Allergy''' | | '''Rheum / Immune / Allergy''' | ||
|bgcolor="Beige"| [[systemic lupus erythematosus]], [[autoimmune adrenalitis]] | | bgcolor="Beige" | [[systemic lupus erythematosus]], [[autoimmune adrenalitis]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Sexual''' | | '''Sexual''' | ||
|bgcolor="Beige"| No underlying causes | | bgcolor="Beige" | No underlying causes | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Trauma''' | | '''Trauma''' | ||
|bgcolor="Beige"| [[crush syndrome]] | | bgcolor="Beige" | [[crush syndrome]] | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Urologic''' | | '''Urologic''' | ||
|bgcolor="Beige"| No underlying causes | | bgcolor="Beige" | No underlying causes | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Dental''' | | '''Dental''' | ||
|bgcolor="Beige"| No underlying causes | | bgcolor="Beige" | No underlying causes | ||
|- | |- | ||
|-bgcolor="LightSteelBlue" | |- bgcolor="LightSteelBlue" | ||
| '''Miscellaneous''' | | '''Miscellaneous''' | ||
|bgcolor="Beige"| [[Amyloidosis]] - Renal, [[burns]], [[dehydration]], [[fasting]], [[hypothermia]], [[internal bleeding]], [[intravenous infusion]], [[malignant hyperpyrexia]], [[phlebotomy]] complication, [[rhabdomyolysis]], [[sea snake poisoning]], selective impairment of [[potassium]] excretion, [[strenuous exercise]], [[transplant rejection]], [[tumor lysis syndrome]], ureterojejunostomy | | bgcolor="Beige" | [[Amyloidosis]] - Renal, [[burns]], [[dehydration]], [[fasting]], [[hypothermia]], [[internal bleeding]], [[intravenous infusion]], [[malignant hyperpyrexia]], [[phlebotomy]] complication, [[rhabdomyolysis]], [[sea snake poisoning]], selective impairment of [[potassium]] excretion, [[strenuous exercise]], [[transplant rejection]], [[tumor lysis syndrome]], ureterojejunostomy | ||
|- | |- | ||
|} | |} |
Latest revision as of 23:11, 29 April 2020
<figure-inline></figure-inline> | Resident Survival Guide |
Hyperkalemia Microchapters |
Diagnosis |
---|
Treatment |
Case Studies |
Hyperkalemia causes On the Web |
American Roentgen Ray Society Images of Hyperkalemia causes |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2]; Raviteja Guddeti, M.B.B.S. [3], Mahmoud Sakr, M.D. [4]
Overview
Hyperkalemia is an elevated blood level (above 5.1 mmol/L) of the electrolyte potassium. ". Extreme degrees of hyperkalemia are considered a medical emergency due to the risk of potentially fatal arrhythmias. Hyperkalemia can be caused by reasons that include increased uptake, extracellular shift, tissue breakdown and impaired excretion from the body.
Causes
Life Threatening Causes
- Hyperkalemia can become a life-threatening condition if potassium levels are too high and body is not able to remove it effectively.
- AKI and chronic renal failure[1]
- Addisonian crisis
- Diabetic ketoacidosis
- Intravenous potassium supplement
- Digoxin toxicity
- Tumor lysis syndrome
Common Causes
The most common causes of hyperkalemia include:[2][3]
- ACE inhibitors
- Acidosis
- Addisonian crisis
- Beta blockers
- Blood transfusion
- Cirrhosis
- Diabetic nephropathy
- High potassium diet
- Malnutrition
- Renal tubular acidosis
Less common causes
- Fasting
- Exercise
- Fluoride toxicity
- Hypoparathyroidism
Genetic causes
- Congenital adrenal hypoplasia
- Hyperkalemic periodic paralysis
- Pseudohypoaldosteronism type1 and type 2
Causes by Organ System
Causes in Alphabetical Order
References
- ↑ De Nicola L, Bellizzi V, Minutolo R, Cioffi M, Giannattasio P, Terracciano V; et al. (2000). "Effect of dialysate sodium concentration on interdialytic increase of potassium". J Am Soc Nephrol. 11 (12): 2337–43. PMID 11095656.
- ↑ Wang WH, Giebisch G (2009). "Regulation of potassium (K) handling in the renal collecting duct". Pflugers Arch. 458 (1): 157–68. doi:10.1007/s00424-008-0593-3. PMC 2730119. PMID 18839206.
- ↑ Giebisch GH, Wang WH (2010). "Potassium transport--an update". J Nephrol. 23 Suppl 16: S97–104. PMID 21170894.
- ↑ Sevastos N et al. (2006) Pseudohyperkalemia in serum: the phenomenon and its clinical magnitude. J Lab Clin Med, 147(3):139-44; PMID 16503244.
- ↑ Don BR et al. (1990) Pseudohyperkalemia caused by fist clenching during phlebotomy. N Engl J Med, 322(18):1290-2; PMID 2325722.
- ↑ Iolascon A et al. (1999) Familial pseudohyperkalemia maps to the same locus as dehydrated hereditary stomatocytosis. Blood, 93(9):3120-3; PMID 10216110.