Patients with certain underlying conditions, such as kidney failure or underactive adrenal glands (Addison’s disease), and those taking diuretic medications in combination with antihypertensive drugs should suspect hyperkalemia and seek medical attention if they suddenly experience a furry sensation on their tongue or tingling notice the skin. Cardiac arrhythmias can be the result of this disorder.
What is hyperkalemia?
Patients with kidney disease should see a doctor if they experience ringing in the ears, muscle weakness, or other unusual symptoms. If symptoms such as cardiac arrhythmia or persistent muscle twitching appear, a doctor must be consulted immediately. See AbbreviationFinder for abbreviations related to hyperkalemia.
With hyperkalemia, the patient’s electrolyte balance is disturbed and the level of potassium in the blood is increased compared to normal. This value should not be higher than 5.0 mmol/l in adults and 5.4 mmol/l in children.
Hyperkalemia usually occurs in chronic kidney failure ; blood pressure-lowering drugs such as ACE inhibitors or diuretics are less common triggers of the disorder. In the patient, it becomes noticeable through a tingling sensation on the skin and a furry feeling on the tongue.
Paralysis and muscle weakness can also occur. If left untreated, hyperkalemia is an extremely dangerous condition because it can lead to cardiac arrhythmias. It can also lead to ventricular fibrillation with subsequent cardiac arrest.
Hyperkalemia refers to an increase in the level of potassium in the blood. In the case of chronic kidney failure, the kidneys can no longer sufficiently excrete the available potassium.
However, since the concentration of potassium is crucial for the transmission of impulses in the heart muscle, cardiac arrhythmias can occur that are life-threatening for the patient. Hyperkalemia can occur intermittently during IV therapy or from red blood cell breakdown, which occurs after extensive burns.
The level of potassium in the blood can also increase during chemotherapy. Hyperkalemia can also occur in the case of severe hyperacidity in the patient, a so-called acidosis. Medications such as beta-blockers and ACE inhibitors used to lower blood pressure, as well as diuretics, may also cause hyperkalemia.
Typical Symptoms & Signs
- Muscle twitching (fasciculation)
- cardiac arrhythmias
- Circulatory arrest (cardiovascular failure)
Diagnosis & History
In the anamnesis interview, the information provided by the patient already allows the first suspicions of hyperkalemia if the patient reports typical symptoms such as a furry feeling on the tongue and tingling on the skin.
Muscle weakness and signs of paralysis as well as ringing in the ears can also occur before the cardiac arrhythmias. The diagnosis of the disorder is made by the doctor based on a laboratory test of the blood. For this purpose, the electrolyte values potassium and sodium as well as calcium and chloride and other enzyme values are determined. Conclusions about kidney function can be drawn from the creatinine value.
Blood pH and acid-base status are also used to diagnose hyperkalemia. Since cardiac arrhythmia can be the result of hyperkalemia and this can be fatal if left untreated, an ECG (electrocardiogram) is also made to check the heart function and to identify any disturbances immediately.
Hyperkalemia can be fatal in some cases, but is not always fatal. For this reason, a competent assessment and treatment by a doctor is required in individual cases. Cardiac complications, which include cardiac arrhythmias, ventricular fibrillation and cardiac arrest, are particularly problematic. Such abnormalities in the heart rhythm can be visualized using an electrocardiogram (ECG).
Hyperkalemia is often due to another condition. Without treatment of the underlying disease (if possible) and hyperkalemia, the condition can worsen. Symptoms of hyperkalemia include paresthesia and muscle weakness. Both can increase the risk of accidents in critical situations (e.g. when driving machines and vehicles or when working on scaffolding).
Injuries and falls that may occur may also need treatment. Hyperkalemia can also cause psychological symptoms such as confusion and hallucinations. They can result in those affected not being aware of their own condition or being unable to communicate clearly. These circumstances can complicate diagnosis and treatment. The confusion of the person concerned can also contribute to the fact that other people also misjudge the situation and are “put off” by it.
When should you go to the doctor?
Patients with kidney disease should see a doctor if they experience ringing in the ears, muscle weakness, or other unusual symptoms. If symptoms such as cardiac arrhythmias or persistent muscle twitching appear, a doctor must be consulted immediately. In the case of serious complications, emergency medical help is required. In the event of a circulatory arrest or signs of a heart attack, the emergency services should be alerted immediately. Accompanying this, first-aid measures must be taken. The patient then has to spend a few days in the hospital. Depending on the course and the underlying disease, further medical check-ups are indicated.
Hyperkalemia occurs in connection with various diseases of the kidneys. These include renal insufficiency, adrenal hypofunction and kidney cancer. There is also an increased risk of too high a potassium level in the blood during chemotherapy or after extensive burns. Those who belong to these risk groups should have the symptoms clarified by a doctor. Suitable contacts are the general practitioner or a nephrologist. In the event of a medical emergency, an ambulance must always be called.
Treatment & Therapy
The treatment of hyperkalemia depends on its cause. If drugs are the cause of the disorder, they are discontinued or replaced with other drugs. Medications that reduce potassium absorption in the gut may also be prescribed.
However, if the potassium level is very high, the patient needs intensive medical care because he is in a life-threatening condition. With constant ECG monitoring, he receives a combination of medications that on the one hand stimulate the kidneys to produce urine and on the other hand promote the absorption of potassium in the body’s cells.
Simultaneous administration of insulin and glucose also promotes potassium absorption. The aim of these measures is to lower the potassium level in the blood and thus protect the heart muscle. Infusions with calcium can also be helpful to prevent cardiac arrhythmias. If these therapeutic measures are not sufficiently effective, the potassium value can also be reduced by blood washing and thus the hyperkalemia can be eliminated.
Outlook & Forecast
The oversupply of potassium in the organism is caused by an existing underlying disease. Therefore, alleviating the symptoms of hyperkalemia depends on the prospect of healing of the disease that has already been diagnosed and treated.
Patients with a tumor have a good chance of recovery if the tumor can be detected early and successfully removed. If no metastases have developed in the body, it usually takes several years for a full recovery. Since hyperkalemia usually develops as a side effect of the cancer therapy that has been initiated, it is only possible to alleviate the symptoms after the necessary chemotherapy has ended. If the cancer is considered cured, the hyperkalemia is also cured. Otherwise, the patient’s treatment is switched to relieving serious symptoms and no attempt is made to cure the hyperkalemia.
In the case of a functional disorder of the kidneys, the excess potassium produced can only be reduced if the treatment of the kidneys is successful or an organ donation has taken place. A kidney transplant can heal if the donor organ has been successfully accepted by the body. Basically, the overall prognosis is based on the existing kidney disease and its treatment options.
If the hyperkalemia arose as a result of medication, the symptoms can be completely reduced in most patients within a short period of time by the use of substitute preparations.
Hyperkalemia is very rare. In certain underlying diseases such as renal insufficiency and Addison’s disease as well as in patients who have to take diuretics and antihypertensive medication, the potassium level in the blood should be checked regularly so that countermeasures can be initiated immediately at the first sign of hyperkalemia.
In the case of hyperkalemia, the measures or the options for aftercare are usually very limited, so that early detection with subsequent treatment is the priority for this disease. A doctor should be contacted at the first signs and symptoms of this disease in order to prevent further complications or further deterioration of the disease. Early diagnosis always has a positive effect on the further course of hyperkalemia.
Most of the time, the disease is treated by taking medication, although some medications must be stopped first. Care should be taken to ensure that the dosage is correct and that it is taken regularly. In the event of interactions or side effects, always consult a doctor first. In severe cases, dialysis may be necessary.
Those affected usually need the support and help of friends and their own family. Loving care and support always has a positive effect on the further course of the disease. Contact with other patients with hyperkalemia can also be useful. In many cases, the life expectancy of those affected is reduced by this disease.
You can do that yourself
Hyperkalemia is a condition that patients cannot diagnose themselves. Often their only symptom is cardiac arrest. In most cases, however, it is detected via a routine blood count check. The treatment of hyperkalemia is based on a medically developed therapy plan, which the patient should follow conscientiously. Essentially, it is about draining the excess potassium from the body and then ensuring that no further excess builds up.
The kidneys are primarily responsible for the excretion of potassium. The patient can support the process by adapting his lifestyle in such a way that the kidney function is strengthened and supported as much as possible. This includes adhering to certain dietary requirements that relieve the kidneys. It is also very important in this context to rinse the kidneys well and thus make their work easier. Patients affected by hyperkalemia should therefore drink a lot during the therapy measure and later also as a preventive measure. Two to three liters a day is ideal. Still mineral water is recommended, but unsweetened fruit teas or diluted juices also have a positive effect on kidney function.
Since hyperkalemia often interacts with other medications, it is necessary for the patient to give their doctor precise information about the medication they are taking and not to take additional therapeutic measures themselves.