Hyperkalemia laboratory findings: Difference between revisions
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==Laboratory Findings== | ==Laboratory Findings== | ||
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!Grade | !Grade | ||
Revision as of 15:45, 31 January 2018
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Resident Survival Guide |
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Hyperkalemia Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Hyperkalemia laboratory findings On the Web |
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American Roentgen Ray Society Images of Hyperkalemia laboratory findings |
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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.[1]
Laboratory Findings
| Grade | Potassium level |
|---|---|
| Mild | 5-7mEq/L |
| Moderate | 7-8.5mEq/L |
| Severe | >8.5mEq/L |
- The first step in diagnosing hyperkalemia is to exclude pseudohyperkalemia by repeating the blood test.
Initial tests
- Complete blood count (CBC)
- Metabolic profile
- Urine potassium, sodium, and osmolality
- Aldosterone
| 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 history of leukamia where the WBC count is >120,000/microL the potassium is raised to cell fragility
- Hereditary (familial) forms of pseudohyperkalemia
References
- ↑ 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.