Many people have no idea what hyperkalemia is. This condition is one of the violations of the water-electrolyte balance. It is associated with an increase in potassium levels in the blood above normal. Often this condition does not produce symptoms, but can lead to serious complications. Hyperkalemia can sometimes be manifested by weakness, irritability, nausea, muscle cramps, arrhythmias. The treatment of electrolyte disorder depends on the cause that led to this condition. Exceeding the normal values of this trace element in the blood requires a diet.
Potassium in the blood
Before you have an idea of what hyperkalemia is, it is necessary to consider the functions of potassium in the body. It is one of the most important electrolytes in the human body. This is the main cation of the intracellular space. Together with sodium, it is necessary to maintain excitability and signal transmission in nerve and muscle cells, including myocardial cells. An appropriate concentration of potassium in the body allows many enzymes to function and determines the maintenance of stability of the internal environment of the body.
Potassium enters the body through the digestive tract. This element is found in many foods, especially fruits, vegetables and nuts. It is mainly excreted by the kidneys, and a small part of it with sweat and feces. The correct level of potassium in the blood is an extremely important parameter for the functioning of the body, therefore it is precisely regulated by determining the balance between its absorption, excretion and movements between cells and blood. Excess potassium, or hyperkalemia, and its deficiency, pose a serious threat to health.
What is hyperkalemia?
Hyperkalemia is a condition in which an abnormally high level of potassium is present in the blood plasma.
The serum potassium level is 3.6–5.2 mmol / L. Depending on the degree of exceeding the normal values of this substance, various types of hyperkalemia are distinguished:
- The level of potassium in the blood - 5.3-5.9 mmol / l, is mild hyperkalemia.
- Moderate hyperkalemia is a condition in which an elevated potassium value is in the range of 6.0-6.4 mmol / L.
- Very high values of this element, the concentration of which exceeds 6.5 mmol / l, occurs with acute hyperkalemia.
It is worth remembering that only in rare cases can one identify a cause that would be associated with a high content of trace elements in the blood. More often this is due to the influence of many different factors.
Symptoms of Potassium Excess
Symptoms of hyperkalemia in humans are very diverse, their occurrence depends on the degree of excess potassium and the rate of increase. It happens that in cases of slowly increasing concentration of this element in the blood, symptoms do not appear, despite the fact that the upper limit of its norm is significantly exceeded.
If an excess of trace elements causes symptoms, most of them are associated with inhibition of conduction in nerve and muscle cells. Regardless of the cause, symptoms of early hyperkalemia are difficult to spot.
They can manifest themselves in the form of:
- feelings of fatigue and irritability;
- muscle weakness and shortness of breath;
- nausea and vomiting
- muscle paralysis;
- cardiac disorders (including life-threatening, for example, ventricular fibrillation, bradycardia), visible on the ECG record;
- chest pains.
A condition in which too much potassium accumulates in the blood serum can even cause impaired consciousness.
Hyperkalemia - pathological causes
The concentration of this trace element in the blood depends on its absorption, excretion and metabolism between cells and blood. The organ that plays the largest role in this process is the kidneys, which, if necessary, have the ability to excrete large amounts of potassium. Therefore, in people with a properly functioning excretory system, hyperkalemia is a rare occurrence, usually associated with excessive intake of potassium in the body or its rapid release from cells.
Given this, among the most common causes of hyperkalemia in the blood, you can list the conditions that make it difficult to excrete potassium through the kidney. They may be associated with kidney disease (e.g., acute or chronic renal failure).
Other conditions that affect an increase in blood levels of an element are as follows:
- adrenal insufficiency;
- heart failure;
- metabolic acidosis, for example, poisoning, sepsis;
- diabetic acidosis with insulin deficiency;
- hemolysis;
- depletion of tumor or leukemia cells;
- tissue hypoxia or impaired water-electrolyte balance.
Hyperkalemia and medications
The conditions to which hyperkalemia belongs should not be ignored. The reasons that cause this condition can also be associated with taking certain medications. Hyperkalemia develops most often when taking certain drugs used for arterial hypertension, certain diuretic drugs, non-steroidal anti-inflammatory drugs (such as Aspirin, Ibuprofen, Naproxen), Cyclosporin, Heparin, and others. These medications affect potassium levels in various ways, for example, by inhibiting its movement from the blood to the cells or inhibiting the elimination.
Most of this element in the body is inside the cells, so their significant damage will lead to the fact that the level of potassium in the blood will be too high. We deal with such a mechanism, for example, in the case of extensive tissue damage (traffic accidents, burns, sepsis, destruction of cancerous tumors). In addition, people taking potassium supplements should be careful not to exceed the dangerous threshold for the presence of this element in the body. It is recommended to take such drugs under the supervision of a doctor and periodically check the level of potassium in the blood so that their use can be stopped in a timely manner.
Hyperkalemia and Food
Hyperkalemia syndrome can be caused by unreasonable consumption of foods containing a large amount of potassium. Therefore, you should reconsider your diet and, if necessary, eliminate some foods, including salt, as well as dried fruits and fresh fruits (for example, bananas, melons, apricots, peaches, citrus fruits, plums, nectarines), legumes and root vegetables, potatoes, avocados, tomatoes , broccoli, parsley. A lot of this element, including in oat, buckwheat, whole grain flour, as well as in meat and sausage. Lovers of sweets with an excess of potassium in the body should limit the intake of chocolate and cocoa.
What can and should people with hyperkalemia eat? Safe foods low in this trace element are white bread, semolina, white rice, yellow cheese, eggs, dairy products, blueberries, water without potassium ions and spices without potassium chloride.
Laboratory tests
The main criterion for the diagnosis of hyperkalemia is an increase in serum potassium above 5.5 mmol / L. For this purpose, a venous blood sample is taken and analyzed automatically. The sampling method is similar to a conventional blood test - it consists of piercing a vein (usually in the elbow) with a sterile needle and collecting blood into a test tube.
It happens that a laboratory result indicating a too high concentration of potassium is not true (the so-called false-positive result). The reason for this may be:
- prolonged squeezing of the shoulder with a tourniquet during blood sampling (more than 2-3 minutes);
- improper storage of biological material;
- blood sampling after taking potassium preparations;
- vein injury during analysis.
In violation of the technique of blood sampling, the result of the analysis may show false hyperkalemia. Therefore, medical staff should be especially attentive. If such errors are suspected, the procedure must be repeated.
The result of this test is interpreted taking into account the presented symptoms, concomitant diseases, medications and other possible causes of hyperkalemia. In order to accurately determine the nature of the disorder, other studies are also performed, such as a general blood test, urinalysis, determination of plasma electrolytes, hormones (especially aldosterone), etc.
Hyperkalemia in ECG results
Advanced hyperkalemia causes noticeable changes in the image of the ECG, as this condition affects the functioning of the heart. With this type of examination, arrhythmia in the work of the heart muscle, bradycardia, or additional convulsions are visible.
In the ECG, an increase in the amplitude of the T wave and the shape of its wedge is most often observed. In the case of a more common disease, the PR interval expands, as does the duration of the QRS complex. In addition, the P wave becomes flatter, and the atrioventricular conduction is weaker. The long-term complex of QRS and T-waves eventually merge, and the ECG curve takes the form of a sinusoid.
In this situation, there is a risk of ventricular fibrillation and, consequently, circulatory arrest.
Hyperkalemia treatment
The causes and symptoms of this condition determine the treatment regimen individually for each patient. Immediate equalization of serum potassium levels to normal values is necessary. Element concentration is reduced by the administration of calcium, glucose with insulin (in the form of intravenous infusions), bicarbonates, beta-agonists and diuretics (such as furosemide). In some cases, an enema is used.
In the treatment of diagnosed renal failure, a limitation of the amount of potassium that enters the body with food is required. The daily dose of this element should not exceed 2 grams. Avoid consuming potassium-rich foods such as potatoes, soybeans, avocados, chocolate, and nuts.
If potassium levels are slightly elevated, changes in diet combined with temporary use of diuretics may be sufficient in treatment. High levels of potassium in the blood (especially above 6.3 mmol / L) can be an immediate threat to life, therefore constant in-patient monitoring of symptoms and treatment of hyperkalemia are required. The cause of this condition may be medications taken by patients with concomitant diseases. Then they should be canceled. The doctor may prescribe "Sodium Polystyrenesulfonate", dissolved in sorbitol, for oral administration or as enemas. It binds and removes excess potassium through intestinal mucus. This method of therapy is especially effective for children and patients with gastrointestinal diseases.
In acute hyperkalemia (more than 6.5 mmol / L) with noticeable changes in the ECG, emergency care is required. Its purpose is to move potassium into the cells. To do this, more often the patient is injected intravenously with a solution of calcium gluconate. It reduces the destructive effect of the trace element on the heart. Such treatment brings immediate results (within a few minutes), but for a short period.
Also, insulin and albuterol can be administered intravenously to the patient. The therapeutic effect of their administration occurs later (after about 1-1.5 hours), and it is also short-lived. In a serious condition of the patient, “Polystyrene sulfonate” is used to remove excess potassium from the body. With renal failure, these treatment procedures will not be enough, sometimes hemodialysis is required.
The effectiveness of treatment is monitored by regularly checking the concentration of potassium in the blood.
Prevention
Preventive measures against this ailment include:
- Limit potassium intake.
- Refusal of potassium-containing drugs.
- The use of loop and thiazide diuretics for the excretion of potassium through the kidneys.
Prevention of hyperkalemia is not a complicated procedure. First of all, you need to carefully monitor your health. If an excess of trace elements is detected in laboratory tests, promptly indicate the possible causes of hyperkalemia to the doctor. Treat diseases on time, preventing the development of serious complications and pathologies.
Complications
Low or high potassium values can kill a person, so all measures for its equalization in the body should be taken immediately.
The consequences of hyperkalemia can be a violation of the heart rhythm, up to its stop. This condition is especially dangerous in that it can occur without preliminary symptoms, against the background of a favorable external health condition.
Doctors reviews
With a lack of potassium in the body, it is better to consume a large amount of food with its high content. Do not take medicines with a microelement without consulting specialists. According to their reviews, hyperkalemia is no less dangerous than mineral deficiency. Uncontrolled potassium intake can cause kidney failure, duodenal ulcer, severe dehydration, and drowsiness that cannot be overcome. Do not use potassium supplements yourself if you are taking medications for heart failure, hypertension, diabetes, or you have kidney disease. This also applies to non-steroidal anti-inflammatory drugs.
When the tendency to hyperkalemia persists, for example, due to the use of certain medications or chronic diseases, it may be effective to use a diuretic that increases urinary potassium excretion (for example, Furosemide). In this case, periodic periodic monitoring of the level of potassium in the blood is also necessary.
Now you know what hyperkalemia is. This ailment is sometimes very severe, but with the timely detection of this pathology, the prognosis in most cases is favorable.