Hyperkalemia is a higher than normal potassium level in the blood. For most people, the potassium level should be between 3.5 and 5.0 millimoles per liter (mmol/L). Hyperkalemia is a potassium level of greater than 5.5.

You may be at risk for high potassium due to: chronic kidney disease; diabetes; congestive heart failure; or taking medications that disrupt potassium balance, such as certain drugs to treat heart failure or lower blood pressure including diuretics, beta-blockers and ACE inhibitors.

Less common causes can include: massive injury resulting in muscle damage; burns over large parts of the body; high-volume blood transfusions; HIV and other infections; and alcoholism or heavy drug use that breaks down muscle fibers, releasing potassium. In some cases, multiple factors may be involved or the cause is never clearly identified.

When potassium is affected

Potassium is needed for normal cell function, including heart muscle cells. The body gets potassium through food. The kidneys maintain the body’s total potassium content by balancing potassium intake with potassium excretion. If intake of potassium outweighs the kidneys’ ability to remove it, or if kidney function decreases, hyperkalemia may occur.

Potassium plays a key role in electric signal functioning of the heart’s middle thick muscle layer, known as the myocardium. Too much potassium can lead to different types of heart arrhythmias. High potassium can be difficult to diagnose; many times there are no symptoms.

“Emergency treatment may be needed if your potassium level is very high...”

How to stay balanced

Dietary changes can help prevent and treat high potassium levels. Talk to your doctor to understand any risk you might have for hyperkalemia. Your doctor may recommend foods that you may need to limit or avoid. These may include asparagus, avocados, potatoes, tomatoes or tomato sauce, winter squash, pumpkin and cooked spinach. Fruits to monitor are oranges and orange juice, nectarines, kiwifruit, bananas, cantaloupe, honeydew, prunes, raisins or other dried fruit.

Also, if you are on a low-salt diet, avoid taking salt substitutes. Emergency treatment may be needed if your potassium level is very high or if there are changes in an electrocardiogram. Treatment may involve administering calcium through an IV to treat muscles and the heart or supplying glucose and insulin through an IV to decrease potassium levels long enough to correct the cause.

Treatment may also include kidney dialysis, if kidney function is deteriorating, as well as water pills (diuretics), and medication to remove potassium from intestines before it is absorbed. If acidosis is the cause, there is sodium bicarbonate. A doctor may also advise stopping or reducing potassium supplements and stopping or changing the doses of certain medicines for heart disease and high blood pressure. Always follow your health care provider’s instructions when taking or stopping medicines.