Hyperkalemia is a pathology that causes abnormally high potassium in the blood. Potassium plays an important role in muscle contractions (including cardiac). It also affects the function of many complex enzymes. Mainly, it is found in bones and skeletal muscles. Together with sodium it contributes to the body homeostasis.
Depending on the degree of severity, hyperkalaemia is divided into the following forms:
In a healthy body, kidneys control the concentration of potassium. When they are healthy, the amount of potassium is sufficient, and the body functions well. If the kidneys are unable to maintain potassium properly, hyperkalemia develops. The most common cause is administration of drugs that block normal potassium excretion from the body. Such drugs are used to treat triamterene and spironolactone. These conditions can cause Addison’s disease: the adrenal glands lose the ability to produce enough hormones, and, as a result, a lot of potassium is released into the blood.
Hyperkalemia does not have very pronounced symptoms. However, there are some signs that can manifest the disease. Most of them are seen on the electrocardiogram:
- Various cardiac arrhythmias;
- ventricular tachycardias;
- pointy T waves on the electrocardiogram;
- an increase in the P-R interval on the electrocardiogram;
- an increase in the ORS interval on the electrocardiogram.
If the cause of this disease is not clear, and the patient does not show any symptoms, pseudohyperkalemia can be suspected.
To diagnose the pathology, the following information should be collected:
First of all, the doctor has to know if the patient takes any medicines that could affect the potassium balance in the body. Certain diet (eating excessive amount of food rich in potassium) can also lead to hyperkalemia, so this fact should also be discussed.
In physical examination, special attention should paid to the blood circulation.
The patient has to take certain tests to determine renin level and aldosterone in plasma.
A medical expert, who deals with hyperkalenia, is called hematologist. The doctor plans the treatment taking into account the disease causes and severity.
Excessive potassium in the blood plasma poses a thread of cardiac arrest. It is urgently needed to reduce it to a safe level. For this purpose, the patient is given an intravenous solution of calcium gluconate or chloride, that protects the heart. If the expected effect is not achieved in a 5-minute interval, the dose is repeated. The injections are done every 3 hours.
Severe forms of hyperkalemia require urgent removal of excessive potassium from the body. The therapy, that prevents complications and stops the development of the disease, is based on the management of glucose, salbutamol, insulin. If the causes cannot be eliminated, and other measures do not help, hemofiltration and hemodialysis without potassium are used.