Hyperkalemia occurs when the potassium levels in your blood are too high. There are several causes of hyperkalemia, but the three main causes are:

  • taking in too much potassium
  • potassium shifts due to blood loss or dehydration
  • not being able to excrete potassium through your kidneys properly due to kidney disease

False elevations of potassium are commonly seen on lab results. This is known as pseudohyperkalemia. When someone has an elevated potassium reading, the doctor will recheck it to make sure it’s a true value.

Certain medications may cause elevated potassium levels as well. This is usually in the setting of someone with acute or chronic kidney disease.

There are several treatment options for hyperkalemia. First, your doctor will make sure that the hyperkalemia hasn’t caused any cardiac changes by having you undergo an EKG. If you develop an unstable heart rhythm due to elevated potassium levels, then your doctor will give you calcium therapy to stabilize your heart rhythm.

If there aren’t any cardiac changes, your doctor will likely give you insulin followed by a glucose infusion. This helps to bring down the potassium levels quickly.

Following this, your doctor may suggest a medication to remove the potassium from your body. Options include a loop or thiazide diuretic medication or a cation exchanger medication. The cation exchangers available are patiromer (Veltassa) or sodium zirconium cyclosilicate (Lokelma).

There are often no warning signs of hyperkalemia. People with mild or even moderate hyperkalemia may not have any signs of the condition.

If someone does have a high enough change in their potassium levels, they may experience muscle weakness, fatigue, or nausea. People may also have cardiac EKG changes showing an irregular heartbeat, also known as an arrhythmia.

If you have severe hyperkalemia, symptoms include muscle weakness or paralysis and decreased tendon reflexes. Hyperkalemia can also cause an irregular heartbeat. If your hyperkalemia causes cardiac changes, you’ll receive treatment right away to avoid a cardiac rhythm that can potentially lead to cardiac arrest.

If you have hyperkalemia, doctors will advise you to avoid certain foods that are high in potassium. You can also make sure to drink plenty of water. Dehydration can make hyperkalemia worse.

There aren’t any specific foods that will lower your potassium level, but there are foods that contain lower levels of potassium. For example, apples, berries, cauliflower, rice, and pasta are all low-potassium foods. Still, it’s important to limit your portion sizes when eating these foods.

You should make sure you avoid foods that are high in potassium. These include fruits such as bananas, kiwis, mangoes, cantaloupe, and oranges. Vegetables that are high in potassium include spinach, tomatoes, potatoes, broccoli, beets, avocados, carrots, squash, and lima beans.

Also, dried fruit, seaweed, nuts, and red meat are rich in potassium. Your doctor can provide you a full list of high-potassium foods.

Hyperkalemia that isn’t properly treated can result in a serious cardiac arrythmia. This can lead to cardiac arrest and death.

If your doctor tells you that your lab results indicate hyperkalemia, you should receive medical attention right away. Your doctor will check your potassium levels again to rule out pseudohyperkalemia. But if you do have hyperkalemia, your doctor will proceed with treatments to bring your potassium levels down.

The occurrence of hyperkalemia within the general population is low. Most people can eat foods that are rich in potassium or be on medications without their potassium levels increasing. People who are most at risk of hyperkalemia are those with acute or chronic kidney disease.

You can prevent kidney disease by leading a healthy lifestyle. This includes controlling your blood pressure, exercising, avoiding tobacco products, limiting alcohol, and maintaining a healthy weight.

Alana Biggers, MD, MPH, FACP, is an internist and an assistant professor of medicine at the University of Illinois-Chicago (UIC) College of Medicine, where she received her MD degree. She also has a Master of Public Health in chronic disease epidemiology from Tulane University School of Public Health and Tropical Medicine and completed a public health fellowship at the Centers for Disease Control and Prevention (CDC). Dr. Biggers has interests in health disparity research and currently has a NIH grant for research in diabetes mellitus and sleep.