Hyperkalemia

(High Potassium)

A high potassium level can occur if you have certain health conditions, including kidney disease or heart failure. But it can also have other causes, including certain medications and heavy alcohol use.

Potassium is an essential electrolyte, which is a mineral your body needs to function correctly. Potassium is especially important for your nerves and muscles, including your heart.
While potassium is important to your health, getting too much of the nutrient can be just as bad as — or worse than — not getting enough.
Normally, your kidneys keep a healthy balance of potassium by flushing excess potassium out of your body. But for many reasons, the level of potassium in your blood can get too high. This is called hyperkalemia, or high potassium.
According to the National Kidney Foundation, normal and high potassium levels, measured in millimoles per liter (mmol/L) of blood, are as follows:

Normal: between 3.5 and 5.0

High: from 5.1 to 6.0

Dangerously high: over 6.0

If potassium levels are low (below 3.4), it’s called hypokalemia. Potassium levels lower than 2.5Trusted Source can be life threatening.

Symptoms of high potassium

The symptoms of high potassium depend on the level of the mineral in your blood. You may not have any symptoms at all. But if your potassium levels are high enough to cause symptoms, you may have:

or weakness

a feeling of numbness or tingling

nausea or vomiting

trouble breathing

chest pain

palpitations or irregular heartbeats

In extreme cases, high potassium can cause paralysis.

Causes of high potassium

Several things can cause hyperkalemia, including health problems and the use of certain medications.

Kidney disease: Having kidney disease can raise your potassium levels because it damages your kidneys. High potassium levels affect 40% to 50% of people with chronic kidney disease. A common cause of advanced kidney disease is hyperkalemia.

Medications: Certain medications have been linked with high potassium levels.

These include:

certain chemotherapy drugs

angiotensin-converting enzyme (ACE) inhibitors

angiotensin receptor blockers

Supplements: Overuse of potassium supplements can increase your potassium levels to a range that’s higher than normal — or even dangerous.

Alcohol use disorder: Heavy alcohol use can cause your muscles to break down. This breakdown can release a high amount of potassium from your muscle cells into your bloodstream.

Excessive burns: Certain kinds of trauma, like excessive burns, can raise your potassium levels. In these cases, extra potassium leaks from your body cells into your bloodstream.

Congestive heart failure: Congestive heart failure (CHF) is a chronic condition that affects your heart’s pumping power. About 40 percent of people with CHF develop high potassium levels.

HIV: HIV can damage your kidney’s filters so they’re less able to efficiently excrete potassium. Some common treatments for HIV, like sulfamethoxazole-trimethoprim therapy, are also associated with elevated potassium levels.

Certain health conditions: High potassium can also be linked to certain health problems, like:

dehydration

type 1 diabetes

Addison’s disease

internal bleeding

When to call your doctor

Because the effects of high potassium can be serious, it’s important to address this condition right away.
Call your doctor right away if you have any of the symptoms above and you’ve been diagnosed with high potassium or have reason to think you have it. Call 911 or go to the nearest emergency room if your symptoms are severe.
You may want to ask your doctor some of the following questions:

How much potassium is right for me?

What could be causing my high potassium level?

What changes should I make to my diet to lower this level?

If I need medication, will there be any side effects?

How often will I need follow-up blood tests?

How high potassium is diagnosed

A blood test can help your doctor diagnose hyperkalemia. Your doctor will routinely do blood tests during your annual checkup or if you’ve recently started a new medication. Any problems with your potassium levels will show up on these tests.
If you’re at risk of high potassium, it’s important to have regular checkups. This is because you may not be aware you have high potassium levels until you start developing symptoms.

Treatment for high potassium

The typical goal of treatment for high potassium levels is to help your body get rid of the excess potassium quickly and to stabilize your heart.
Hemodialysis

If you have high potassium due to kidney failure, hemodialysis is your best treatment option. Hemodialysis uses a machine to remove waste from your blood, including excess potassium, when your kidneys can’t filter your blood effectively.
Medications

Your doctor may also prescribe drugs to treat your high potassium levels. These may include:
Diuretics

Your doctor might first prescribe diuretics, which are pills that cause you to urinate more. Some diuretics increase the amount of potassium excreted by the kidneys, while others don’t increase potassium excretion.
Resin

In some cases, you may receive a medication called a resin to take by mouth. Resin binds with potassium, allowing it to be removed from your body during your bowel movements.
Emergency medication treatments

As an urgent treatment to lower very high potassium levels, medications may need to be administered through an IV in a hospital.
Unlike diuretics and resin, these medications have only a temporary effect. They stabilize your potassium level and help reduce the effect it has on your heart.
These medications include:

calcium gluconate

calcium chloride

insulin and glucose, or insulin alone for people with hyperglycemia (high blood sugar)

sodium bicarbonate

Managing high potassium

If your high potassium is severe, you must get treatment right away. But if you have mild high potassium, you may be able to lower your potassium levels by making changes to your diet.
According to the National Kidney Foundation, a low potassium diet can include up to 2,000 milligrams (mg) of potassium each day. Low potassium foods generally contain 200 mg or less per serving.
Foods that are safe to eat

The following foods are low in potassium:

fruits like apples, berries, cherries, and grapefruit

vegetables including green beans, peas, eggplant, mushrooms, and kale

protein sources like eggs, poultry, canned tuna, and beef

cakes, cookies, and pies that don’t contain chocolate, nuts, or fruits high in potassium

Beverages with low potassium:

water

tea

coffee

Foods to avoid

The following foods and beverages are high in potassium and should be avoided or eaten in moderation:

fruits like bananas, avocados, oranges, and raisins

vegetables including artichokes, Brussels sprouts, potatoes, tomatoes, and tomato-based products like juice, sauce, and paste

nuts, seeds, and peanut butter

beans like baked beans, black beans, lentils, and legumes

some herbs and herbal supplements, including alfalfa, coriander, nettle, and turmeric

milk and yogurt

chocolate

Some salt substitutes are also high in potassium. When you buy a salt substitute, make sure to avoid any that list potassium chloride as an ingredient.
Foods that are high in additives, like commercial baked goods and sports drinks, are also usually high in potassium.

Complications from high potassium

If left untreated, high potassium levels can lead to the following complications:

weakness

arrhythmia, a heart disorder that affects the rate or rhythm of your heartbeats

heart attack

cardiac arrest, an extremely serious condition where your heart stops beating

Preventing high potassium

To help prevent high potassium levels, you can do the following:

following a low-potassium diet

avoiding salt substitutes

avoiding herbal supplements. Some may contain ingredients that increase your potassium levels

following your treatment plan

If you have heart disease, kidney disease, or another serious health condition, carefully stick to your healthcare professional’s treatment plan outlook
Because symptoms of high potassium may not appear in the early stage, you should get regular blood tests if you’re at risk for this condition.
If your blood tests show that you have high potassium levels, your doctor will choose the treatment plan that’s right for you.

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