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{{Hyperkalemia}} | {{Hyperkalemia}} | ||
{{CMG}}; '''Associate Editor(s)-In-Chief:''' [[Priyamvada Singh|Priyamvada Singh, M.B.B.S.]] [mailto: | {{CMG}}; '''Associate Editor(s)-In-Chief:''' [[Priyamvada Singh|Priyamvada Singh, M.B.B.S.]] [mailto:psingh13579@gmail.com], [[Jogeet Singh Sekhon]] | ||
==Overview== | ==Overview== | ||
Hyperkalemia often has no symptoms. Occasionally, people may have the following symptoms: irregular heartbeat, nausea, slow, weak, or absent pulse. Extreme degrees of hyperkalemia are considered a [[medical emergency]] due to the risk of potentially fatal [[arrhythmia]]s. A detailed history taking is very helpful in diagnosing the cause of hyperkalemia. | |||
==[[ | ==History== | ||
A detailed history taking is very helpful in diagnosing the cause of [[hyperkalemia]].<ref name="pmid21181208">{{cite journal| author=Lehnhardt A, Kemper MJ| title=Pathogenesis, diagnosis and management of hyperkalemia. | journal=Pediatr Nephrol | year= 2011 | volume= 26 | issue= 3 | pages= 377-84 | pmid=21181208 | doi=10.1007/s00467-010-1699-3 | pmc=3061004 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21181208 }} </ref><ref name="pmid2711969">{{cite journal| author=Chakko SC, Frutchey J, Gheorghiade M| title=Life-threatening hyperkalemia in severe heart failure. | journal=Am Heart J | year= 1989 | volume= 117 | issue= 5 | pages= 1083-91 | pmid=2711969 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2711969 }} </ref><ref name="pmid8039632">{{cite journal| author=Agarwal R, Afzalpurkar R, Fordtran JS| title=Pathophysiology of potassium absorption and secretion by the human intestine. | journal=Gastroenterology | year= 1994 | volume= 107 | issue= 2 | pages= 548-71 | pmid=8039632 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8039632 }} </ref> | |||
* Dietary history<ref name="pmid18759636">{{cite journal| author=Youn JH, McDonough AA| title=Recent advances in understanding integrative control of potassium homeostasis. | journal=Annu Rev Physiol | year= 2009 | volume= 71 | issue= | pages= 381-401 | pmid=18759636 | doi=10.1146/annurev.physiol.010908.163241 | pmc=4946439 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18759636 }} </ref> | |||
** Potassium supplements in herbal supplements, salt substitutes | |||
** Fruits, dried fruits, juices, banana and vegetables | |||
*Medication history | |||
** [[Nonsteroidal anti-inflammatory drugs]] | |||
** [[Angiotensin-converting enzyme inhibitors]] | |||
** [[Angiotensin receptor blockers]] | |||
** Potassium-sparing diuretics, especially popular in the treatment of [[cirrhosis]] and [[congestive heart failure]] | |||
** [[Cyclosporine]] or [[tacrolimus]] | |||
** [[pentamidine]] | |||
*Medical history<ref name="pmid8039632">{{cite journal| author=Agarwal R, Afzalpurkar R, Fordtran JS| title=Pathophysiology of potassium absorption and secretion by the human intestine. | journal=Gastroenterology | year= 1994 | volume= 107 | issue= 2 | pages= 548-71 | pmid=8039632 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8039632 }} </ref><ref name="pmid16083995">{{cite journal| author=Nagasaki A, Takamine W, Takasu N| title=Severe hyperkalemia associated with "alternative" nutritional cancer therapy. | journal=Clin Nutr | year= 2005 | volume= 24 | issue= 5 | pages= 864-5 | pmid=16083995 | doi=10.1016/j.clnu.2005.06.009 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16083995 }} </ref><ref name="pmid577961">{{cite journal| author=Sopko JA, Freeman RM| title=Salt substitutes as a source of potassium. | journal=JAMA | year= 1977 | volume= 238 | issue= 7 | pages= 608-10 | pmid=577961 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=577961 }} </ref><ref name="pmid18759636">{{cite journal| author=Youn JH, McDonough AA| title=Recent advances in understanding integrative control of potassium homeostasis. | journal=Annu Rev Physiol | year= 2009 | volume= 71 | issue= | pages= 381-401 | pmid=18759636 | doi=10.1146/annurev.physiol.010908.163241 | pmc=4946439 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18759636 }} </ref> | |||
** [[Renal failure]]<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> | |||
** [[Diabetes mellitus]]<ref name="pmid7447584">{{cite journal| author=Nicolis GL, Kahn T, Sanchez A, Gabrilove JL| title=Glucose-induced hyperkalemia in diabetic subjects. | journal=Arch Intern Med | year= 1981 | volume= 141 | issue= 1 | pages= 49-53 | pmid=7447584 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7447584 }} </ref> | |||
** [[Sickle cell disease]] or trait | |||
** [[Urinary tract obstruction]] - | |||
** Type IV [[renal tubular acidosis]], also called hyperkalemic renal tubular acidosis. It can be seen with [[polycystic kidney disease]], [[amyloidosis]] and diabetes mellitus. | |||
** The combination of [[abdominal pain]], [[hypoglycemia]] and [[hyperpigmentation]], often in the context of a history of other [[Autoimmune diseases|autoimmune disorders]], may be signs of [[Addison's disease]], itself a medical emergency. | |||
==Symptoms== | |||
* [[Hyperkalemia]] often has no symptoms and the problem may be detected during screening [[blood test]]s for another medical disorder, or it may only come to medical attention after complications have developed. | |||
* Patients may present with symptoms such as: | |||
**[[Nausea]] | |||
**[[Malaise]] | |||
**[[Palpitations]] | |||
**[[Muscle weakness]] | |||
**Mild breathlessness (may indicate [[respiratory acidosis]]) | |||
==References== | ==References== | ||
{{reflist|2}} | |||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2], Jogeet Singh Sekhon
Overview
Hyperkalemia often has no symptoms. Occasionally, people may have the following symptoms: irregular heartbeat, nausea, slow, weak, or absent pulse. Extreme degrees of hyperkalemia are considered a medical emergency due to the risk of potentially fatal arrhythmias. A detailed history taking is very helpful in diagnosing the cause of hyperkalemia.
History
A detailed history taking is very helpful in diagnosing the cause of hyperkalemia.[1][2][3]
- Dietary history[4]
- Potassium supplements in herbal supplements, salt substitutes
- Fruits, dried fruits, juices, banana and vegetables
- Medication history
- Nonsteroidal anti-inflammatory drugs
- Angiotensin-converting enzyme inhibitors
- Angiotensin receptor blockers
- Potassium-sparing diuretics, especially popular in the treatment of cirrhosis and congestive heart failure
- Cyclosporine or tacrolimus
- pentamidine
- Medical history[3][5][6][4]
- Renal failure[7]
- Diabetes mellitus[8]
- Sickle cell disease or trait
- Urinary tract obstruction -
- Type IV renal tubular acidosis, also called hyperkalemic renal tubular acidosis. It can be seen with polycystic kidney disease, amyloidosis and diabetes mellitus.
- The combination of abdominal pain, hypoglycemia and hyperpigmentation, often in the context of a history of other autoimmune disorders, may be signs of Addison's disease, itself a medical emergency.
Symptoms
- Hyperkalemia often has no symptoms and the problem may be detected during screening blood tests for another medical disorder, or it may only come to medical attention after complications have developed.
- Patients may present with symptoms such as:
- Nausea
- Malaise
- Palpitations
- Muscle weakness
- Mild breathlessness (may indicate respiratory acidosis)
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.
- ↑ Chakko SC, Frutchey J, Gheorghiade M (1989). "Life-threatening hyperkalemia in severe heart failure". Am Heart J. 117 (5): 1083–91. PMID 2711969.
- ↑ 3.0 3.1 Agarwal R, Afzalpurkar R, Fordtran JS (1994). "Pathophysiology of potassium absorption and secretion by the human intestine". Gastroenterology. 107 (2): 548–71. PMID 8039632.
- ↑ 4.0 4.1 Youn JH, McDonough AA (2009). "Recent advances in understanding integrative control of potassium homeostasis". Annu Rev Physiol. 71: 381–401. doi:10.1146/annurev.physiol.010908.163241. PMC 4946439. PMID 18759636.
- ↑ Nagasaki A, Takamine W, Takasu N (2005). "Severe hyperkalemia associated with "alternative" nutritional cancer therapy". Clin Nutr. 24 (5): 864–5. doi:10.1016/j.clnu.2005.06.009. PMID 16083995.
- ↑ Sopko JA, Freeman RM (1977). "Salt substitutes as a source of potassium". JAMA. 238 (7): 608–10. PMID 577961.
- ↑ 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.
- ↑ Nicolis GL, Kahn T, Sanchez A, Gabrilove JL (1981). "Glucose-induced hyperkalemia in diabetic subjects". Arch Intern Med. 141 (1): 49–53. PMID 7447584.