Hyperkalaemia

Hyperkalaemia is an electrolyte disorder characterised by an abnormally high concentration of potassium in the blood. Potassium is essential for normal nerve signalling, muscle contraction, and heart function, but excessive levels can interfere with the electrical activity of the heart. Mild hyperkalaemia may cause no noticeable symptoms, while more significant elevations can lead to muscle weakness, fatigue, numbness, palpitations, or dangerous cardiac rhythm disturbances.

Common causes include chronic kidney disease, acute kidney injury, certain medications, excessive potassium intake in susceptible individuals, and conditions that cause potassium to move from cells into the bloodstream. Drugs such as potassium-sparing diuretics, ACE inhibitors, and angiotensin receptor blockers may increase the risk. Diabetes and adrenal disorders can also contribute.

Diagnosis generally involves a blood test measuring serum potassium, supported by kidney-function tests and an electrocardiogram when levels are significantly elevated. Treatment depends on the severity and underlying cause. Management may include stopping contributing medicines, dietary adjustments, medications that promote potassium removal, or urgent therapies to protect the heart and rapidly lower potassium in severe cases. Early recognition and appropriate treatment are important to prevent potentially life-threatening complications.