Hyperkalemia laboratory findings
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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] ; 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
Hyperkalemia is defined as serum potassium greater than 5.0-5.5 mEq/L in adults. Levels higher than 7 mEq/L can lead to significant hemodynamic and neurologic consequences, whereas levels exceeding 8.5 mEq/L can cause respiratory paralysis or cardiac arrest and can quickly be fatal. 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.
| Grade | Potassium level |
|---|---|
| Mild | 5-7mEq/L |
| Moderate | 7-8.5mEq/L |
| Severe | >8.5mEq/L |
Initial tests
- Complete blood count (CBC)
- Metabolic profile
- Urine potassium, sodium, and osmolality
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)