Hyperkalemia Treatment
When you have too much potassium in your blood, it’s called hyperkalemia. There are two types of hyperkalemia: acute and chronic. Acute hyperkalemia is a sudden, severe rise in blood potassium levels. Chronic hyperkalemia tends to be milder but lasts for longer time.
Even if you’re not having any symptoms, hyperkalemia can affect your heart and other parts of your body, so it’s important to treat it. The type of treatment you get depends on whether it’s acute or chronic and what’s causing it. Generally, acute hyperkalemia needs emergency treatment, whereas chronic hyperkalemia can be managed with medication and diet changes.
Emergency Hyperkalemia Treatment
If your blood potassium is too high, you may need emergency hyperkalemia treatment. Go to the hospital if you have trouble breathing, extreme muscle weakness, severe abdominal pain, or symptoms of a heart attack.
“We treat [acute hyperkalemia] pretty aggressively with several medications all at once,” says Natalie Kreitzer, associate professor of Clinical Emergency Medicine at the University of Cincinnati. Most of these medications are given through an IV.
These medications include:
- Albuterol (inhaled)
- Calcium gluconate (IV)
- Insulin and glucose (IV)
- Sodium bicarbonate (IV)
Drugs such as insulin and albuterol work by moving potassium out of the blood and into cells. Meanwhile, calcium fixes the balance of potassium in the heart, preventing arrhythmias. These medications start working in a few minutes, although they don’t fix the root cause.
People with very high blood potassium levels may also need dialysis, which uses a special machine to filter the potassium from your blood.
Potassium-Lowering Medications
Even if hyperkalemia isn’t a crisis, you still need to get your potassium levels down. Medications can help with this.
Medications to lower potassium include:
Water pills (diuretics). These rid the body of extra fluids, flushing the extra potassium out through your pee.
Potassium-binding drugs. These are powders that you mix with your food. Once in your intestines, they attach themselves to potassium. This causes the extra potassium to come out in your poop. Some common ones are patiromer (Veltessa), sodium polystyrene sulfonate (Kayexalate), and sodium zirconium cyclosilicate (Lokelma).
Lifestyle Changes for Hyperkalemia
Mild hyperkalemia treatment usually includes medication and diet changes. In some cases, you may need to adjust medications you are already taking. Your doctor can help you figure out the best plan for you.
Medications that cause hyperkalemia
Some medications can cause high potassium levels. These medications include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs). These include pain relievers such as aspirin, ibuprofen, and naproxen.
- High blood pressure drugs. Some can block a hormone that controls potassium levels.
- Herbal supplements. Ask your doctor about which ones might be a hidden source of potassium.
- Potassium supplements. These can add extra potassium to your body.
Don’t change your medication without talking to your doctor first. Your doctor may recommend lowering your dose of these medications or stopping them entirely. Many things can cause hyperkalemia, and you want to make sure that you have the right culprit. Plus, many medications that cause hyperkalemia are very important for your overall health, such as drugs for high blood pressure. Your doctor will help you figure out the best plan for tackling your hyperkalemia.
Hyperkalemia diet
Many foods contain potassium. If your kidneys don’t work well or you have heart failure, eating too much potassium could lead to hyperkalemia (if you’re healthy, potassium in your diet generally isn’t a problem). Your doctor will ask you about what you eat and drink, and then advise you on what things you may need to limit, as they have a lot of potassium.
Avoid high-potassium foods, such as:
- Raisins
- Apricots
- Prunes
- Dates
- Bananas
- Strawberries
- Watermelon
- Honeydew
- Cantaloupe
- Juice (especially orange, prune, and tomato juice)
- Beans
- Peas
- Spinach
- Beets
- Tomatoes (and tomato-based foods like tomato sauce and ketchup)
- Mushrooms
- Squash
- Potatoes
- Sweet Potatoes
- Avocadoes
- Asparagus
- Turkey
- Beef
- Fish
- Salt substitutes that have potassium
It can be challenging to adjust to a new diet. A dietitian can help you find a meal plan that’s right for you. You can also join support groups or find recipes online because they have a lot of potassium.
Dialysis for Hyperkalemia
Your kidneys help control the balance of potassium in your body, and if they don’t work properly, they can’t do that important job. So, you might need dialysis to treat your kidney disease — which also treats hyperkalemia.
Treating the Underlying Cause of Hyperkalemia
Ultimately, high potassium treatment depends on how severe it is and what’s causing it. This means it’s important to find the root cause.
If you have high potassium levels, talk to your doctor. They can help you figure out what’s causing it. You may need treatment for heart failure or kidney problems, or need to adjust some medications you’re currently taking. Treating the underlying problem can help you manage the potassium levels in your blood.
Takeaways
Hyperkalemia, or high potassium levels in the blood, can cause heart arrhythmias and other problems. High potassium treatment depends on how severe it is, whether it came on suddenly, and what’s causing it. Mild, chronic hyperkalemia can usually be treated with medication and diet changes. If you have sudden hyperkalemia along with trouble breathing, extreme muscle weakness, abdominal pain, or symptoms of a heart attack, go to the emergency room.
Hyperkalemia Treatment FAQs
How long does hyperkalemia treatment take to work?
Emergency hyperkalemia treatment starts to work within a few minutes. Medications for chronic hyperkalemia might need a few days to work.
Will hyperkalemia go away on its own?
If you’re healthy and have mild hyperkalemia, your kidneys might be able to take care of it on their own. But if you have complications or underlying conditions, you’ll probably need further treatment.
Can hyperkalemia be cured?
If you have chronic hyperkalemia from medications or an underlying condition, it’s likely to come back.
Does drinking water reduce hyperkalemia?
It depends on what’s causing it. If you’re dehydrated, drinking water might help. But if you have an underlying condition, you might need medicine.
What is the first-line treatment for high potassium levels?
It depends on the cause and severity. For acute hyperkalemia, the first treatment is usually calcium. This helps prevent arrhythmias.
How do you feel when your potassium is too high?
If you have mild hyperkalemia, you might get nausea, diarrhea, and stomach pain, or no symptoms at all. If your potassium is dangerously high, you may have chest pain, heart palpitations, heart arrhythmia, and muscle weakness or numbness.
Show Sources
Photo Credit: Caiaimage / Sam Edwards / Getty Images
SOURCES:
Natalie Kreitzer, associate professor, Clinical Emergency Medicine, University of Cincinnati.
American Kidney Fund: “High Potassium (Hyperkalemia): Causes, Prevention and Treatment.”
Cleveland Clinic: “Hyperkalemia (High Blood Potassium).”
Medscape: “Hyperkalemia in Emergency Medicine.”
National Kidney Foundation: “Hyperkalemia (High Potassium).”
Cleveland Clinic Journal of Medicine: “Diagnosis and Treatment of Hyperkalemia.”
U.S. Pharmacist: “Updated Treatment Options in the Management of Hyperkalemia.”
The New England Journal of Medicine: “Sodium Zirconium Cyclosilicate in Hyperkalemia.”
Vascular Risk Health Management: “Blocking the RAAS at Different Levels.”
