Treatement of Hyperkalemia or Elevated Serum Potassium Levels

Potassium is one of such elements in the blood whose concentration above or below the normal range can be fatal. The most dreaded outcome of high or low potassium levels in the blood is sudden death due to fatal cardiac arrest. In this article I will be discussing the treatment of Hyperkalemia or increased levels of Potassium in the blood.

Step 1

Treat promptly after the diagnosis is confirmed by the blood test. If levels are mildly elevated patient may just need restriction of potassium supplements (which is the most important cause of hyperkalemia) and fruits rich in potassium such as banana.

Step 2

Admit all patients who have life threatening hyperkalemia to the Intensive Care Unit. Cardiac monitoring is vital.

Step 3

Promptly administer intravenous calcium. This shields the heart from potentially life threatening abnormal heart rhythms induced by the potassium.

Step 4

Give Insulin intravenously along with concentrated dextrose solution called D50. Insulin is known to move the potassium present in the blood inside the cells. This however is only a temporary measure because in few hours the potassium will move back to the blood. However, this technique helps to buy time until the excess potassium is excreted through kidneys. Dextrose is only given to prevent insulin from causing hypoglycemia (low glucose levels)

Step 5

Give intravenous Sodium Bicarbonate to buffer the blood. This also helps to shift potassium from the blood in to the body cells and promotes excretion of potassium through the kidneys.

Step 6

Give Abuterol by nebulization or by intravenous infusion. This will also shift excessive potassium into the cells.

Step 7

Give diuretics such as Furosemide or HCTZ. This will allow kidneys to excrete excess potassium in urine.

Step 8

Give cation exchange resin such as Sodium Polystyrene Sulfonate (SPS, Kayexalate) either orally or as a retention enema. This resin takes up potassium in the gut and stops it from getting absorbed in to the blood.

Step 9

Perform hemodialysis if the conservative measures listed above are ineffective or if the hyperkalemia is very severe, or if the patient has marked tissue breakdown and is releasing large amounts of potassium from the injured cells.

Warnings Prevent future episodes of hyperkalemia by following measures: Use of a low potassium diet. Avoid the use of drugs that raise the plasma potassium concentration. Minimize episodes of fasting