Why is calcium used for hyperkalemia?

Written by Wang Li Bing

Intensive Care Medicine Department

Updated on September 20, 2024

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Hyperkalemia can increase the excitability of myocardial cells, leading to various malignant arrhythmias and even sudden death. Immediate treatment is necessary after hyperkalemia occurs. Clinically, it can be treated by hemodialysis or conservatively with medication. Why use calcium preparations for hyperkalemia? Because after using calcium preparations, the excitability of myocardial cells can be stabilized, effectively maintaining stable heart rates in patients and preventing sudden death due to malignant arrhythmias.

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Written by Wei Shi Liang

Intensive Care Unit

42sec

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The effects of hyperkalemia on the body

Hyperkalemia affects the body mainly in three aspects. Firstly, hyperkalemia impacts muscle tissues, clinically manifesting as symptoms such as muscle tremors. Secondly, the effect of hyperkalemia on the heart primarily manifests as decreased excitability, conductivity, and automaticity of the myocardium. It affects electrocardiograms, characterized by a depressed P wave, widened QS wave, reduced R wave, and elevated T wave. Thirdly, hyperkalemia affects acid-base balance; during hyperkalemia, potassium efflux from cells can lead to metabolic acidosis, resulting in alkaline urine.

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Written by Wei Shi Liang

Intensive Care Unit

45sec

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Causes of Hyperkalemia

Common causes of hyperkalemia in clinical settings include: First, it is related to excessive intake. Generally, a high-potassium diet under normal kidney function does not cause hyperkalemia. It only occurs when there is excessive or rapid intravenous potassium supplementation, or when kidney function is impaired. Second, hyperkalemia caused by reduced excretion. Common reasons include renal failure, lack of adrenocortical hormones, and primary renal tubular potassium secretion disorders, all of which can cause hyperkalemia. Third, a large transfer of potassium ions from inside the cells to the outside can also cause hyperkalemia.

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Written by Tang Zhuo

Endocrinology

1min 28sec

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Hyperkalemia is seen in which diseases?

When serum potassium levels exceed 5.5 millimoles per liter, it is referred to as hyperkalemia. Elevated serum potassium does not reflect an overall increase in body potassium, but due to limitations in testing methods, the clinical diagnosis of hyperkalemia still relies on combining serum potassium levels with electrocardiogram history. The causes of hyperkalemia are complex and commonly include: First, decreased renal potassium excretion, seen in acute kidney failure or insufficiency in adrenal cortical hormone synthesis and secretion, or long-term use of potassium-sparing diuretics; Second, shifts of potassium from inside the cells, often due to hemolysis, tissue damage, large-scale necrosis of tumors and inflammatory cells, shock, burns, excessive muscle contractions, acidosis, or injection of hypertonic saline or mannitol, which causes dehydration inside cells and leads to potassium leakage, resulting in hyperkalemia; Third, excessive intake of potassium-containing medications, such as high doses of potassium penicillin; Fourth, transfusion of stored blood can lead to hyperkalemia; Fifth, digitalis poisoning can cause hyperkalemia.

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Written by Gan Jun

Endocrinology

59sec

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How to treat vomiting caused by hyperkalemia?

For patients with hyperkalemia, early symptoms include numbness in the limbs, weakness, muscle soreness, and paralysis. As the condition progresses, it can suppress myocardial function, reducing the tension of the myocardium and leading to slow heartbeats, and even cause arrhythmias and cardiac arrest. Increased release of acetylcholine can also cause nausea, vomiting, abdominal pain, and other symptoms. Patients with this condition generally also exhibit symptoms of hyperlipidemia and metabolic acidosis. For mild cases of hyperkalemia, temporary treatment may not be necessary, and symptomatic treatment such as stopping vomiting and drinking water may be sufficient. However, in acute cases, it is recommended that the patient immediately undergo dialysis or receive diuretic injections to rapidly eliminate potassium ions from the body, and to stop consuming foods and medications that contain potassium.

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Written by Zhao Xin Lan

Endocrinology

1min 24sec

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Causes of hyperkalemia

The causes of hyperkalemia may include: First, excessive intake, such as consuming too much high-potassium food, medications with high potassium content, including some traditional Chinese medicines, potassium penicillin, stored blood, and excessive potassium supplementation. Second, it could be due to decreased potassium excretion by the kidneys. When renal insufficiency, acute or chronic renal failure occurs, it is often accompanied by severe hyperkalemia. Third, there is also decreased potassium secretion by renal tubules. When there is a deficiency of corticosteroids, there can be degenerative, asymptomatic hyperkalemia. Hyperkalemia can also occur when renal tubules are insensitive to aldosterone. Fourth, medications that reduce potassium excretion, such as the use of potassium-sparing diuretics, angiotensin-converting enzyme inhibitors, other nonsteroidal anti-inflammatory drugs, cyclosporine, etc., can also cause hyperkalemia. Fifth, the shift of potassium from inside the cells to the extracellular fluid, which can be caused by tissue damage, hypoxia, or the use of certain medications, leading to hyperkalemia.