Hyperkalaemia (high potassium): diet and other care

Potassium is an essential mineral for our health, as it helps in the communication between nerves and muscles, contributes in the digestion process and also in the functioning of the metabolism.

Through a balanced diet it is possible to ingest adequate amounts of the nutrient. The banana , for example, is one of the most popular foods containing potassium, but beyond that there is also the coconut water, tomato sauce and spinach.

But attention needs to be maintained, as some conditions or changes in the body can cause hyperkalaemia, in which potassium is in very high levels in the blood.

What is hyperkalaemia?

Hyperkalaemia is caused by an increase in potassium in the blood , which causes problems with the functioning of the organism, which can lead to vomiting, nausea and respiratory changes.

The condition can be caused by a number of factors, such as reduced urine elimination (due to obstruction of the urinary canal), use of medications, kidney diseases, use of potassium supplements, or even due to injuries or physical trauma.

A nephrologist or general practitioner are the professionals to make the diagnosis and treat the condition, which is usually diagnosed by means of blood tests.

Treatment depends on the degree of hyperkalaemia, which can be mild, moderate or severe.

In general, the condition is curable when treated with discipline, combined with a good diet and medications prescribed by the specialist.

The change can be found in ICD-10 under the code E87.5.

What is potassium and what is it for?

Our body is not able to produce minerals like potassium, but they are essential for our health. Therefore, we need to eat them for food.

This mineral is found in several types of foods and drinks, such as bananas and coconut water. To ensure the balance in the functioning of the organism it is important to consume the correct amount of the nutrient.

The substance is responsible for a number of functions, such as:

  • Participates in the regulation of blood flow;
  • Maintains normal water balance (water distribution in the body);
  • Participates in muscle contractions;
  • Helps nerve impulses (connections between neurons);
  • Aids in digestion;
  • Controls the rhythm of the heart;
  • Balances the pH (acidity) of the blood.

Degrees of hyperkalaemia

Hyperkalaemia has degrees and can be mild, moderate or severe, which is assessed with blood tests. Depending on what the diagnosis is, each one has a way of being treated.

Mild hyperkalaemia

Mild hyperkalaemia is around 5.5 mEq / L and 6.5 mEq / L and the treatment consists mainly of dietary change, with a reduction in potassium intake.

It will also be necessary to assess other factors that may be triggering the condition, such as some medication or pictures of irregular kidney function.

In general, the symptoms are usually mild and the condition is treated without difficulty.

Moderate to severe hyperkalaemia

In this case, the situation is more delicate, as the level of potassium needs to be reduced immediately from the body. Moderate hyperkalaemia is between 6.5 mEq / L and 8.0 mEq / L, and above 8.0 mEq / L the condition is considered severe.

As the potassium level is considered high in these stages, the heart needs to be monitored from the beginning of the treatment in order to avoid possible cardiac arrests.

In general, calcium is administered to protect the heart, insulin and also glucose to aid in the elimination of potassium from the blood.

What is the normal level of potassium in the blood?

The values ​​considered normal for potassium in the body are around 3.6 to 5.3 mEq / L. When the level is greater than 5.5 mEq / L, hyperkalemia occurs, and below that amount it is classified as hypokalemia .

In cases that exceed the value of 6 mEq / L, the condition is critical and emergency, and can be fatal to the victim.

Causes

There are two systems that can cause an excessive increase in potassium in the blood: the irregular elimination of the nutrient naturally present inside the cells or the decrease in kidney work, causing potassium to accumulate in the body.

Among the main causes that lead to these conditions are:

Diet with excess potassium

The average daily intake of potassium should be between 1000mg to 2000mg, which is equivalent to a teaspoon (5g).

In general, feeding alone is not the only cause of hyperkalaemia, but it can facilitate or trigger the condition in patients with predisposition.

Some foods should be consumed in moderation by patients with cardiac, renal, diabetes or who use drugs that interfere with potassium levels, such as:

  • Nuts;
  • Potatoes;
  • Banana;
  • Dairy products;
  • Avocados;
  • Fast foods;
  • Processed meats (such as sausages);
  • Spinach;
  • Tomatoes.

Read more:  Healthy Eating: what it is, benefits, how to have it, menu, tips

Rejection of a transplanted kidney

When a kidney transplant operation is performed, it may happen that our body’s own defense rejects the transplanted kidney. In this case, drugs are used to make the immune system adapt to the new organ.

However, if there is rejection of the organ, kidney functions are impaired and potassium can accumulate in the body.

Decreased kidney function

The person who has a kidney failure (in which the kidneys lose the ability to function properly) of the acute or chronic type, needs to observe and perform tests constantly.

This is due to the use of drugs to treat the disease, because over time these drugs can affect the hydroelectrolytic balance (balance of water ingested and lost in the body).

When the balance is affected, the kidneys are unable to eliminate potassium, resulting in an accumulation that can later become complicated and generate a case of hyperkalaemia.

Obstructive uropathy

Obstructive uropathy is a disease that causes blockage of the flow of urine, which can affect the functioning of the kidneys. In this way, there is an accumulation of substances that should be eliminated in the urine, such as potassium.

Diabetic ketoacidosis

Insulin, a hormone that acts in the regulation of blood sugar, facilitates the entry of potassium in cells and, therefore, prevents the nutrient from accumulating in the blood.

Ketoacidosis is caused when the blood sugar level is too high, usually due to uncontrolled or undiagnosed diabetes. Therefore, excess blood sugar may be related to the increase in potassium.

Potassium supplementation

Potassium is acquired through food, but in some diets supplements of vitamins and minerals containing potassium are added. Depending on the supplement the level of this mineral can be high, resulting in an accumulation in the blood.

Some medications

The use of certain medications, such as diuretics or supplements that provide doses of the mineral, can influence the development of hyperkalaemia.

Among them are non-steroidal anti-inflammatory drugs (used to treat pain), angiotensin-converting enzyme (ACE) inhibitors, heparin (used in thrombosis) and cyclosporine (to prevent transplant rejection).

It is important that every medication is prescribed by the doctor and the treatment is conducted under observation.

Traumas or injuries

In some cases, such as burns or serious accidents, intense involvement of the muscle tissue can occur, causing the release of intracellular substances, a condition known as rhabdomyolysis.

In these cases, the potassium, present in the cell, is leaked into the blood and accumulates.

Risk factors

There are other reasons, in addition to consuming foods with excess potassium, which can influence the onset and development of hyperkalaemia. Are they:

  • Age (women in their 50s);
  • Glomerulonephritis (inflammation of the kidneys);
  • Obstructive uropathy (blockage of urinary flow);
  • Injuries, trauma or burns;
  • Addison’s disease;
  • Rhabdomyolysis;
  • Hemolytic anemia;
  • Inflammation of the glomerulus (inflammation that affects the kidneys)
  • Gastrointestinal bleeding;
  • Surgeries;
  • Tumors;
  • Use of potassium-based supplements;
  • Use of medicines for heart disease or high blood pressure.

What are the symptoms of hyperkalaemia?

 

Hyperkalaemia does not always manifest symptoms, but when they do appear, the patient may experience:

  • Change in heart rate;
  • Nausea and vomiting;
  • Muscle weakness;
  • Fainting;
  • Palpitations;
  • Headaches;
  • Hallucinations;
  • Alteration of hearing and vision;
  • Dizziness;
  • Pressure drop (hypotension);
  • Difficulty breathing;
  • Pains in the chest region;
  • Muscle aches.

Diagnosis

A nephrologist or general practitioner are the professionals to diagnose and treat the condition. Hyperkalaemia can be identified by means of a blood test, in which the measurement of potassium in the plasma (liquid part of the blood) is checked.

Usually, the condition is first detected when blood tests are performed. To identify the cause, doctors also evaluate the person’s history and also the medications the patient usually takes.

Additional tests may still be necessary to diagnose the source of the change, such as diabetes mellitus, acidosis, muscle breakdown or kidney disorders.

Among the most common tests are:

Electrocardiogram (ECG)

On the electrocardiogram (ECG) the electrical impulses of the heart are monitored, being a painless and fast procedure.

Since the high rate of potassium can cause changes in heart rate, the test provides information on how your heart is beating and your health.

The ECG takes around three minutes to be performed, being done by means of electrodes (similar to adhesives), which are fixed on the patient’s chest, generating images that are evaluated by the responsible physician.

Urine tests

Tests performed with urine collection can indicate or evaluate hyperkalaemia, pointing out the inadequate functioning of the kidneys, as well as obstructions or infections.

The exams are done with a simple urine collection, in a non-invasive and non-painful way.

Is there a cure?

-Yeah . When treatment is taken seriously, the condition can usually be cured with a change in diet and treatments that eliminate the source of the problem.

Although most conditions are solved without major complications, sometimes the condition can evolve and cause complications, even causing the patient’s death.

What is the treatment?

Hyperkalaemia is usually treated by medications prescribed by the doctor along with a low-potassium diet. Each degree of hyperkalaemia has its treatment recommendations.

Some therapy options include:

Diet

 

Combined with the use of medications, a low potassium diet is essential in the treatment. Salt is restricted and controlled (around 3 grams per day) and foods such as milk, meat and cola-based soft drinks are prohibited.

For legumes ( beans , soybeans, peas, lentils, chickpeas), vegetables (legumes) and tubers ( potatoes , cassava, yams) it is necessary to peel, chop and cook them.

Food monitoring is important for healthy exchanges to be made, without any nutritional damage.

Evaluation of medicines

Some medications may be responsible for the elevation of potassium in the body. Between them:

  • Potassium supplements;
  • Medicines for heart disease and hypertension (diuretics and beta-blocking agents)
  • Immunosuppressants;
  • Chemotherapy
  • Blockers of angiotensin receptors;
  • Angiotensin-converting enzyme inhibitors.

In such cases, it is important to talk to the doctor so that he can evaluate the possibility of changing or adjusting the dosages if necessary.

Hemodialysis

In more severe cases, usually when there is an impairment of renal function or severe rhabdomyolysis, it is necessary to carry out treatment with hemodialysis due to the high degree of potassium in the blood.

The procedure consists of cleaning and filtering the blood, which helps in the elimination of substances such as potassium.

The number of sessions and the duration of treatment depend on the patient’s condition, but generally the treatment has a quick and effective response.

Medicines

Medicines used to treat hyperkalaemia need to be prescribed by the specialist.

In general, to eliminate excess potassium from the blood, medications such as:

  • Polystyrenesulfonate ( Sorcal , Calnate );
  • Sodium bicarbonate ;
  • Insulin + glucose;
  • Diuretics (has a side effect, but can be used if prescribed by a doctor).

Attention!

NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained in this website is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.

Living together

After diagnosing the condition, some measures can be taken to help with treatment:

Make food exchanges

Attention will be needed with food, so as not to overdo the consumption of those that may contain considerable levels of potassium. Pay attention to product labels to find out about the amounts of potassium and prefer a lighter and more natural diet.

Drink water

Consume plenty of water because, in addition to helping the whole body function, it causes excess potassium to be expelled in the urine.

Urinary retention problems are also favored and minimized with adequate fluid intake.

Take care of health

Maintaining health care is essential. With the practice of light physical exercises, such as walking, and a balanced diet, the whole organism is benefited.

Also, do not forget to make regular visits to the doctor and also do tests requested by the specialist.

Prognosis

Hyperkalaemia is a disease that has a cure, but for this it is necessary to carry out the treatment in the correct way so that the condition is reestablished.

Often, the condition manifests itself silently, without showing any expressive symptoms, making the treatment take a long time to begin.

However, most patients have good responses to therapy and do not suffer from sequelae or aggravating factors.

Complications

If the potassium levels do not decrease, the condition evolves and can cause some problems, such as:

Cardiac arrest

The change in potassium can cause cardiac arrhythmias, a condition in which the heartbeat is affected. In some cases, the condition can worsen and cause cardiac arrest. It usually affects older patients with a history of renal failure.

Difficulty breathing

When hyperkalaemia occurs to a high degree, problems affect breathing. Weakness, chest pain and difficulty in breathing can be caused by the alteration in the contraction and relaxation of the muscles of the respiratory tract.

Changes in neuromuscular control

Neuromuscular control is responsible for bringing sensory information to the brain, so that there is muscle function. High-grade hyperkalaemia can cause changes in neuromuscular control, causing mobility problems.

Prevention

Some attitudes can help prevent the development of the disease, they are:

  • Take care of the food;
  • Do physical activities;
  • Avoid excessive consumption of potassium;
  • Use supplements under medical advice;
  • Maintain regular doctor visits.

What is the difference between hyperkalaemia and hypokalemia?

Excess of the mineral in the body, classified as hyperkalaemia, or reduction of the substance, called hypokalemia, can occur. That is, the difference consists of the amount of potassium in the blood.

Understand the differences better:

Hypokalemia (hypokalemia)

Low potassium can cause symptoms such as muscle cramps, fatigue , constipation , constant vomiting and diarrhea . Generally, the condition is also diagnosed in people who regularly use diuretic medications.

To treat the disease, medicines are used to help correct the potassium deficit, combined with a diet with foods and drinks recommended by the doctor.

Hyperkalaemia (hyperkalemia)

The excess of the mineral has as symptoms extreme fatigue, muscle spasms , weakness, colic, constipation, nausea or vomiting and irregular heartbeat.

In the treatment, the doctor prescribes medicines that can reduce the amount of potassium in the body, together with a diet, which in this case avoids foods with a high concentration of potassium.


Hyperkalaemia is a disease caused by excess potassium in the body, which can cause milder or more intense symptoms. The condition sometimes takes time to manifest symptoms and, therefore, being attentive to health in general and maintaining regular consultations is essential.

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