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> | ||
| [[Hyperkalemia resident survival guide|Resident <br> Survival <br> Guide]] | | [[Hyperkalemia resident survival guide|Resident <br> Survival <br> Guide]] | ||
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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. | ||
==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=== | ||
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* [[Malnutrition]] | * [[Malnutrition]] | ||
* [[Renal tubular acidosis]] | * [[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 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]], [[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="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 | ||
|- | |- | ||
|} | |} |
Revision as of 14:30, 16 July 2018
<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.
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.