Hyperkalemia means that the potassium levels in your blood are too high.
High potassium occurs most often in people with chronic kidney disease (CKD). This is because the kidneys are responsible for getting rid of excess potassium and other electrolytes like salt.
Other causes of hyperkalemia include:
- metabolic acidosis
- certain medications
Hyperkalemia usually doesn’t have any symptoms.
To find out your potassium levels, your healthcare provider will order a blood test. According to the National Kidney Foundation, a blood potassium level higher than 5 mmol/L indicates hyperkalemia.
Untreated hyperkalemia can be life threatening, resulting in irregular heartbeats and even heart failure.
It’s important to follow your healthcare provider’s advice and take steps to lower your potassium levels.
Your treatment will depend on:
- how severe your hyperkalemia is
- how quickly it’s come on
- what’s causing it
Here are several ways you can lower your blood potassium levels.
Acute hyperkalemia develops over the course of a few hours or a day. It’s a medical emergency that requires treatment in a hospital.
At the hospital, your doctors and nurses will run tests, including an electrocardiogram to monitor your heart.
Your treatment will depend on the cause and severity of your hyperkalemia. This may include removing potassium from your blood with potassium binders, diuretics, or in severe cases, dialysis.
Treatment may also include using a combination of intravenous insulin, plus glucose, albuterol, and sodium bicarbonate. This helps move potassium from your blood into your cells.
It can also treat metabolic acidosis, another common condition associated with CKD, which occurs when there’s too much acid in your blood.
Chronic hyperkalemia, which develops over the course of weeks or months, can usually be managed outside of the hospital.
Treating chronic hyperkalemia usually involves changes to your diet, changes to your medication, or starting a medication such as potassium binders.
You and your healthcare provider will also carefully monitor your potassium levels.
Diuretics and potassium binders are two common types of medication that can treat hyperkalemia.
Diuretics increase the flow of water, sodium, and other electrolytes like potassium out of the body. They’re a common part of treatment for both acute and chronic hyperkalemia. Diuretics can reduce swelling and lower blood pressure, but they can also cause dehydration and other side effects.
Potassium binders work to treat hyperkalemia by increasing the amount of potassium your body excretes through bowel movements.
There are several types of potassium binders that your doctor may prescribe, such as:
- sodium polystyrene sulfonate (SPS)
- calcium polystyrene sulfonate (CPS)
- patiromer (Veltassa)
- sodium zirconium cyclosilicate (Lokelma)
Patiromer and sodium zirconium cyclosilicate are two relatively new treatments for hyperkalemia. Both of these may be especially effective options for people with heart disease or diabetes, as they enable continued use of certain medications that can lead to hyperkalemia.
Certain medications can sometimes cause hyperkalemia. High blood pressure medications known as renin-angiotensin-aldosterone system (RAAS) inhibitors can sometimes lead to high potassium levels.
Other drugs associated with hyperkalemia include:
- nonsteroidal anti-inflammatory drugs (NSAIDs)
- beta-blockers for high blood pressure
- heparin, a blood thinner
- calcineurin inhibitors for immunosuppressive therapy
Taking potassium supplements can also lead to high potassium levels.
It’s important to talk with your healthcare providers about any and all medications and supplements you take to help determine the cause of your hyperkalemia.
This will also allow them to make the right recommendations for lowering your potassium.
If your hyperkalemia is caused by a medication you currently take, your healthcare provider may recommend changing or stopping that medication.
Or, they may recommend certain changes to your diet or the way you cook. If diet changes don’t help, they may prescribe a hyperkalemia medication, like potassium binders.
Your healthcare provide may recommend a low potassium diet to manage your hyperkalemia.
There are two easy ways to naturally lower the amount of potassium you eat, which are:
- avoiding or limiting certain high potassium foods
- boiling certain foods before you eat them
High potassium foods to limit or avoid include:
- root vegetables such as beets and beet greens, taro, parsnips, and potatoes, yams, and sweet potatoes (unless they’re boiled)
- bananas and plantains
- prunes and prune juice
- sun-dried or pureed tomatoes, or tomato paste
- beans (like adzuki beans, kidney beans, chickpeas, soybeans, etc.)
- potato chips
- French fries
- salt substitutes
High potassium drinks to limit or avoid include:
- fruit or vegetable juice (especially passion fruit and carrot juices)
Boiling certain foods can lower the amount of potassium in them.
For example, potatoes, yams, sweet potatoes, and spinach can be boiled or partially boiled and drained. Then, you can prepare them how you normally would by frying, roasting, or baking them.
Boiling food removes some of the potassium. However, avoid consuming the water you’ve boiled the food in, where potassium will remain.
Your doctor or nutrition specialist will also likely recommend you avoid salt substitutes, which are made from potassium chloride. These can also increase your blood potassium levels.
Your healthcare provider will work with you to find the right treatment to manage your chronic hyperkalemia or help you avoid an acute episode.
Changing your medication, trying a new medication, or following a low potassium diet can all help.