Hyperkalaemia- Raised Potassium

Hyperkalaemia is defined as serum potassium level higher than 5.5 mmol/L.

Causes of raised potassium plasma levels- Haemolysed blood and prolonged or tight application of torniquet shift of potassium from blood cells to blood plasma by mechanical trauma Lab errors Thrombocytosis Leukocytosis ( ^^ WBC ) Lab errors Infectious mononucleosis Leukaemia Familial psedohyperkalaemia Dietary Supplements Total parenteral nutritional formulas Pencillin G Potassium therapy PRBC tranfusion Once GFR falls < 15-20 sig hyperkalaemia can occur even in abscence of an abnormally large K+ load Potassium sparing diuretics NSAIDs ACE inhibitors Angiotensin receptor blockers Cyclosporine or Tacrolimus Trimethoprim -sulfamethoxazole Heparin Ketoconazole Herbs Diabetes mellitus Sickle cell disease or Trait Lower urinary tract obstruction Adrenal insufficiency Primary Addison's syndrome ( Autoimmune dis , TB or infarct ) Enzyme deficiencies Genetic disorders Metabolic acidosis Beta adrenergic blockade Acute tubular necrosis Electrical burns Thermal burns Cell depolarization Head trauma Digitalis toxicity Digitalis toxicity Methotrexate Rhabdomyolysis Tumour lysis syndrome Cyclosporine

Approach-Often incidental laboratory finding Rarely associated with symptoms Compains may be vague Ocassionally patients may c/o palpitations , nausea , muscle pain or paraesthesia , generalised fatigue Clinical affects are due to pathological effects of ↑ K+ conc on generation of action potentials in excitable tissues...