aetiology

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Hyperkalaemia can be due to:

  • impaired excretion
    • acute kidney injury/ chronic kidney disease
    • medications
      • angiotensin-converting enzyme inhibitors and angiotensin receptor blockers
      • NSAID’s
      • potassium sparing diuretics
      • trimethoprim
      • heparin
      • lithium
    • decreased distal renal flow
      • acute kidney injury/ chronic kidney disease
      • congestive heart failure
      • cirrhosis
    • hypoaldosteronism
      • adrenal insufficiency
      • adrenocorticotropic hormone deficiency
    •  primary renal tubular defects
      • sickle cell disease
      • SLE
      • amyloidosis
      • obstructive urpathy
  • transcellular shift
    • insulin deficiency/resistance
    • exercise
    • acidosis
    • tissue necrosis or lysis (rhabdomyolysis, tumour lysis syndrome, severe burns)
    • hypertonicity
      • hyperglycaemia
      • mannitol
    • medications
      • beta blockers
      • digoxin toxicity
      • somatostatin
    • cell breakdown/leakage
  • increased intake
    • potassium supplementation
    • red blood cell transfusion
    • foods high in potassium
      • figs
      • molasses
      • seaweed
      • chocolates
      • bran cereal
      • vegetables (spinach, tomato, mushroom, carrots)
      • dried fruits and nuts
      • fruits (banana, kiwi fruit, orange, mango) 
    • protein calorie supplements
    • penicillin G potassium
  • spurious hyperkalaemia (also called pseudohyperkalaemia) (1,2)

Note:

  • healthy individuals usually increase excretion when there is excess potassium consumption. Hence dietary-induced hyperkalaemia usually involves concurrent renal insufficiency (1,2).

Reference:

Last edited 02/2018 and last reviewed 07/2021

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