Hyperkalemia: From the Inside Out

The video above may be viewed at hyperkalemiainsights.com

Most people know potassium is an essential nutrient, but many do not recognize that too much potassium in the blood can be dangerous. Hyperkalemia is a medical term that describes a potassium level in the blood that's higher than normal. Hyperkalemia is a serious medical condition which can result in abnormal heart rhythms and sudden death.1,2 Read more below to find out why it’s important for the body to maintain a potassium balance, and what happens if it doesn’t.

Potassium is a key mineral and an essential electrolyte required for life. It regulates electrical activity across cells as well as the processes essential for helping the heart to beat properly and muscles to contract.2 Potassium is measured by a blood test, and normally ranges from 3.5 to 5.0 millimoles per liter. Too much or too little potassium can be dangerous for the body.

Hyperkalemia is the term used to describe potassium levels that are too high, and hyperkalemia can be chronic, meaning it lasts for months or years. Hypokalemia is the term used to identify low potassium levels. Both conditions can have serious consequences. To help keep blood potassium in check, the body has biological systems to maintain the potassium level in the normal range. The process whereby the body works to maintain stable and appropriate potassium levels in the blood is referred to as homeostasis.2

Under normal conditions, the maintenance of a normal potassium level in the blood is not a problem; your body can handle it, no matter what you eat.3 Bananas come to mind for most people when considering foods that are rich in potassium, but artichokes and avocados can contain more than twice as much potassium. The kidneys are key to maintaining homeostasis as they excrete most of the excess dietary potassium from our bodies (about 90% of it), while the remainder is removed by the gastrointestinal tract.2

As potassium excretion by the kidneys decreases with advancing chronic kidney disease, homeostasis breaks down and potassium levels then begin to rise, frequently leading to recurrent or chronic hyperkalemia.3 This is why hyperkalemia is such an important issue for people with chronic kidney disease.

As kidney function worsens, the body uses additional compensatory mechanisms to clear excess potassium.3 Once these compensatory systems reach their limit, potassium levels will continue to rise, resulting in hyperkalemia.3 One approach to helping the body manage potassium levels involves the use of medications that bind and remove secreted potassium from the colon.4 

The exact level at which excess potassium will cause heart arrhythmias and problems is difficult to predict and varies from patient to patient.3 This type of uncertainty motivates doctors and healthcare providers to take preventative action. Until recently, options have been limited for patients with hyperkalemia. Diets low in potassium frequently have been used to treat hyperkalemia, but they can be challenging to stick to, as they may limit intake of healthy fruits and vegetables. High doses of diuretics may also be utilized for treatment for hyperkalemia but can be associated with multiple negative side effects. Thus, the development of new approaches and strategies for the treatment of hyperkalemia are warranted, given the associated risks for arrhythmia and death with the condition, and the limited options available for treating recurrent or chronic hyperkalemia in patients with chronic kidney disease.

References:

1 Bushinsky DA, et al., Kidney Int. 2015
2 Rastegar A, et al., Postgrad Med J. 2001;77:759-64
3 Evans KJ, et al., J Intensive Care Med. 2005;20:272-90
4 Chaitman, M, et al., P&T. 2016; 41(1): 43-50