Overview
Hyperkalaemia is an elevated serum potassium level that can predispose to cardiac arrhythmias.
Look For
- Serum potassium >5.0mmol/L.
Aetiology
Causes of Hyperkalaemia
Factitious
- Haemolysis (e.g. poor collection, delay in lab processing)
- Leukocytosis / thrombocytosis
Increased Intake / Production
- Exogenous administration - massive transfusion, potassium supplements, TPN
- Endogenous production - rhabdomyolysis
Reduced Excretion
- Renal failure - acute or chronic
- Medications - NSAIDs, ACE inhibitors, ARBs, spironolactone, trimethoprim
- Addison's
Compartmental Shift
- Type 4 renal tubular acidosis
- Metabolic acidosis
- Hyperglycaemia
- Beta blockers
- Trauma / burns
Clinical Features
Signs and Symptoms
- Paraesthesia
- Flaccid paralysis
- Hypotension
- Bradycardia
- Arrhythmia
ECG Changes
- Tall (tented) T-waves
- QRS widening
- Loss of P waves
- Sine waves
- VT / VF / asystole
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