The effects of hyperkalemia on the body

Written by Wei Shi Liang

Intensive Care Unit

Updated on September 02, 2024

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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

34sec

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Does hyperkalemia cause a fast or slow heart rate?

Hyperkalemia often causes a slowed heart rate and is associated with various arrhythmias. When serum potassium is between 6.6 to 8.0 mmol/L, tented T-waves may be observed. When serum potassium levels rise rapidly, it can lead to ventricular tachycardia or even ventricular fibrillation. On the other hand, a slow increase in serum potassium can cause conduction blocks, and in severe cases, may lead to cardiac arrest. These are the heart rate changes caused by hyperkalemia, which typically result in a slower heart rate.

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Written by Wei Shi Liang

Intensive Care Unit

46sec

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What are the symptoms of hyperkalemia?

Mild hyperkalemia can affect muscle tissues, causing mild muscle tremors, while severe hyperkalemia may reduce the excitability of neuromuscular functions, leading to weakness and even flaccid paralysis in the limbs. Hyperkalemia can also impact the heart, mainly resulting in decreased myocardial excitability, decreased myocardial conductivity, and decreased myocardial automaticity. The effects on the electrocardiogram (ECG) primarily manifest as low and widened P waves, widened QS complexes, decreased R waves, and elevated T waves. Regarding myocardial contractility, hyperkalemia mainly causes a decrease in contractility and can lead to metabolic acidosis.

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Written by Wei Shi Liang

Intensive Care Unit

1min

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The impact of hyperkalemia on the heart

The effects of hyperkalemia on the heart mainly manifest in the following ways: First, it affects the excitability of the myocardium, as hyperkalemia can cause reduced or even absent myocardial excitability; second, it impacts myocardial conductivity. In hyperkalemia, due to the reduced resting potential, the amplitude and speed of the action potential's phase zero decrease, leading to slowed excitability spread and reduced conductivity; third, it influences the automaticity of the myocardium. In hyperkalemia, due to slowed automatic depolarization, the automaticity is reduced. Additionally, hyperkalemia produces characteristic changes in the electrocardiogram, such as depression or disappearance of the P wave, prolongation of the PR interval, widening of the S wave, and narrowing and peaking of the T wave, which are the main changes in the electrocardiogram due to hyperkalemia.

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Written by Wei Shi Liang

Intensive Care Unit

45sec

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How to rescue hyperkalemia

Hyperkalemia must be dealt with immediately once it occurs. The usual treatments in clinical settings include promoting potassium excretion using furosemide or other loop diuretics to maximize renal potassium excretion, or using oral or rectal potassium-eliminating agents. For life-threatening hyperkalemia with serum potassium levels greater than 6.5 mmol/L, hemodialysis is necessary. Another approach is to facilitate the shift of potassium into cells, which is done through the administration of insulin with glucose, or sodium bicarbonate along with calcium gluconate that helps protect the myocardium, thus providing treatment and protective measures for hyperkalemia.

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Written by Luo Juan

Endocrinology

1min

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What should be noted in the diet for hyperkalemia?

In cases of hyperkalemia, it is important to avoid eating foods high in potassium, such as corn, lettuce, carp, eel, lamb, beef, pork, as well as dates, bananas, and others. These foods are rich in potassium and should be consumed less or not at all. Additionally, a diet high in sugar and fat should be provided, or some intravenous nutrition may be used, to ensure sufficient caloric intake and prevent the release of potassium from metabolic breakdown, which could lead to an increase in blood potassium levels. Also, it is important to avoid certain medications high in potassium, such as traditional Chinese medicines. (Medication use should be under the guidance of a professional doctor.)