Hyperkalemia: Elevated Blood Potassium (K+) Levels
Fact Sheet
Overview
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If not treated, people with hyperkalemia can be at risk for abnormal
heart rhythms and sudden death.1
In the United States, approximately 3 million people with stage 3 &
4 chronic kidney disease (CKD) and/or heart failure have
hyperkalemia.2 As the number of people with these diseases
continues to climb, more people are expected to experience
hyperkalemia.
Because hyperkalemia can be a recurrent condition in patients with
ongoing risk factors, daily management may be required.
Cause
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Potassium (K+) is an electrolyte that is important for normal functioning of the heart. About 98 percent of
potassium in the body is found inside cells,3 with the remainder in the blood.
In healthy people, normal blood potassium levels are maintained when potassium intake via the diet is
balanced with uptake of potassium by the cells and excretion by the kidneys.4 When the kidneys are not
functioning properly, the body can’t effectively remove potassium from the body, causing blood potassium
levels to be out of balance.4
Hyperkalemia, or too much potassium in the blood, occurs when there is a defect in one or more of the
mechanisms that maintain this balance,3 most commonly because excretion of potassium by the kidneys is
decreased.4 This can be due to acute kidney failure or decreasing kidney function such as in CKD, advancing
age, certain medical conditions, or medications commonly used in people with cardiovascular and kidney
disease.3
Diagnosis
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A blood test can determine the level of potassium in the blood.
The typical target range for blood potassium is 3.5 mEq/L to 5.0 mEq/L;1
hyperkalemia is considered to be a blood potassium level >5.0 mEq/L.
Studies have shown that CKD patients with blood potassium levels >5.5
mEq/L have a higher risk of dying within 24 hours.5
Signs & Symptoms
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There are often no warning signs, meaning a person can unknowingly have elevated levels of potassium.6 When
symptoms do occur, weakness and fatigue are the most common. People with hyperkalemia also may
experience:
 Muscle paralysis
 Shortness of breath
 Heart palpitations
 Chest pain
 Nausea or vomiting
 Paresthesias (tingling sensation of the skin)
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Charlotte Arnold
direct 650.421.9352
email [email protected]
Hyperkalemia as a Side Effect
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Some medicines that are frequently prescribed to people with CKD and heart failure, such as NSAIDs (aspirin)
and beta blockers, can cause hyperkalemia as a side effect.4
One well documented class of medicines that can cause hyperkalemia as a side effect is renin angiotensin
aldosterone system (RAAS) inhibitors, often prescribed to people with CKD and heart failure to help delay
disease progression.
Commonly prescribed RAAS inhibitor medicines include:
 Angiotensin receptor blockers (ARBs)
 Mineralocorticoid receptor antagonists (MRAs)
 Angiotensin-converting enzyme (ACE) inhibitors
Challenges of Long-Term Management
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For people with hyperkalemia, treatments are available to quickly lower elevated potassium in an emergency
setting, such as insulin administered with glucose, b-adrenergic agonists, calcium gluconate and dialysis.4 The
immediate goals of emergent therapies are to stabilize the heart and push excess potassium back into the cells.
For those with an ongoing risk of recurrent hyperkalemia:
o Dietary restriction of potassium is an important component of managing hyperkalemia. This is difficult
because potassium is found in many popular and healthy foods, including bananas, oranges, potatoes, milk,
artichokes, avocados, cantaloupes, raisins, squashes, tomatoes, steaks and hamburgers.
o The drug sodium polystyrene sulfonate (SPS) was developed for the treatment of hyperkalemia more than
50 years ago, and its label warns of potential gastrointestinal injuries.
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1
Rastegar A, Soleimani M. Hypokalaemia and hyperkalaemia. Postgrad Med J. 2001;77:759-764.
USRDS 2011, Truven data, and CDC.
3 Evans KJ, Greenberg A. Hyperkalemia: a review. J Intens Care Med. 2005;20(5):272-290.
4 Weiner ID, Linas SL, Wingo CS. Disorders of Potassium Metabolism. In: Johnson R, Fluege J, Feehally J, eds. Comprehensive Clinical Nephrology.
4th ed. Philadelphia, PA: Saunders Elsevier; 2010:118-129. Brown RS. Potassium homeostasis and clinical implications. Am J Med. 1984:3-10.
5 Einhorn at al. Arch Intern Med. 2009;169(vol 12);1156.
6 Kraft MD, Btaiche IF, Sacks GS, et al. Treatment of electrolyte disorders in adult patients in the intensive care unit. Am J Health-Syst Pharm.
2005;62:1663-1682. Weiner ID, Linas SL, Wingo CS. Disorders of Potassium Metabolism. In: Johnson R, Fluege J, Feehally J, eds. Comprehensive
Clinical Nephrology. 4th ed. Philadelphia, PA: Saunders Elsevier; 2010:118-129.
2
MEDIA CONTACT:
100 Cardinal Way
Redwood City, CA 94063
PP-US-CRP-00033 ©2015 Relypsa. All rights reserved.
Relypsa and the Relypsa logo are trademarks of Relypsa.
Charlotte Arnold
direct 650.421.9352
email [email protected]