To function normally, your body requires a delicate balance of electrolytes, including potassium.

Potassium is an essential electrolyte for normal nerve and muscle function, including your heart. Too much potassium in the blood can cause the heart to beat irregularly and can sometimes result in death.

A high potassium level in the bloodstream is known as hyperkalemia. Although hyperkalemia can affect anyone, there are some people who are more at risk for developing the condition.

Risk factors for hyperkalemia include:

  • some medical conditions
  • certain medications
  • diet

Here’s everything you should know about the causes behind this condition.

The kidneys work to maintain the body’s ideal balance for potassium and other electrolytes.

The risk of unbalanced electrolytes increases when the kidneys aren’t working properly. That means that those with underlying kidney conditions are at a higher risk of developing hyperkalemia.

Chronic kidney disease (CKD) is the most common cause of hyperkalemia. The rate of hyperkalemia in people with CKD has been reported to be as high as 73 percent.

Other medical conditions can increase your risk, including:

  • congestive heart failure
  • diabetes
  • Addison’s disease, which is when your body doesn’t produce enough hormones
  • high blood pressure

Less common medical causes of hyperkalemia include:

  • burns that cover large areas of the body or severe injuries
  • certain infections, such as HIV
  • tumors
  • cell and muscle damage due to alcoholism or heavy drug use

Receiving treatment and managing medical conditions such as diabetes can reduce your risk of hyperkalemia.

If high potassium levels persist, your healthcare provider may recommend treatments like diuretics or potassium binders.

Certain medications can contribute to the development of hyperkalemia. Medications that treat blood pressure-related conditions are the most common culprits.

Medications that can lead to high potassium include:

  • angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs)
  • potassium-sparing diuretics, such as spironolactone, amiloride, and triamterene
  • beta-blockers
  • nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen
  • calcineurin inhibitors
  • potassium-based salt substitutes
  • potassium dietary supplements
  • heparin, a blood thinner
  • antibiotics such as trimethoprim and pentamidine

Nonprescription drugs and supplements can also increase the likelihood of increased blood potassium.

This includes supplements such as:

  • milkweed
  • Siberian ginseng
  • Hawthorn berries
  • noni juice
  • alfalfa
  • dandelion
  • horsetail
  • nettle

In general, people with kidney disease who are already at risk of developing hyperkalemia should refrain from taking herbal supplements.

Talk to your healthcare provider before taking any new medications or supplements.

If a medication you take for heart disease or high blood pressure is causing hyperkalemia, your healthcare provider will decide best next steps.

This may include stopping the medication or adjusting the dose. It’s important to follow your healthcare provider’s recommendations and have regular checkups to monitor your potassium levels.

Your diet can contribute to your risk of developing hyperkalemia. Adjusting your diet by consuming low-potassium foods or avoiding certain foods that are high in potassium may help.

Your healthcare provider may ask about your diet and suggest limiting or avoiding certain foods. A dietitian can also help you come up with a plan.

Eating too little potassium can be just as harmful, so it’s important to find a healthy balance that works for you.

A few examples of foods that are high in potassium include:

  • vegetables, including avocados, potatoes, tomatoes, Brussels sprouts, broccoli, pumpkin, cooked spinach, and more
  • fruits, such as oranges, bananas, nectarines, kiwi, cantaloupe, honeydew, prunes, and raisins or other dried fruit
  • other foods, including chocolate, nuts, seeds, peanut butter, milk, yogurt, and bran products

On the other hand, foods that are low in potassium are:

  • vegetables, including asparagus, cabbage, cauliflower, cucumber, eggplant, iceberg lettuce, onions, and radishes
  • fruits like apples, berries (blueberries, cranberries, raspberries, strawberries), grapes, pineapple, plums, watermelon, and more
  • other foods, such as rice, noodles, pasta, bread that isn’t whole grain, yellow cake, and cookies that don’t include nuts or chocolate

Be mindful that even though these foods are lower in potassium, you may still need to limit the size of your portions. Almost every food has some potassium in it, so the serving size is important to consider.

You can also remove some of the potassium in foods like potatoes and carrots by leaching them.

To do this, you need to soak the peeled and sliced veggies in water for at least 2 hours. Boiling the vegetables can also pull out some of the potassium content.

Hyperkalemia can lead to serious heart problems if left untreated. If you’re at a higher risk of developing high potassium, there are ways you can reduce your risk.

It’s important to consult your healthcare provider to discuss your medications, diet, and medical conditions. Doing so will make sure you’re on the right path to reducing your hyperkalemia risk factors.