Why should calcium be supplemented for hyperkalemia?

Written by Chen Li Ping

Endocrinology

Updated on February 08, 2025

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When high potassium levels trigger ventricular automaticity, it is recommended to administer calcium to counteract its cardiotoxicity. This is because during hyperkalemia, the excitability of the myocardium significantly increases. Calcium ions do not affect the distribution of potassium inside and outside the cells, but they can stabilize the excitability of the heart. Therefore, even if a patient's blood calcium level is normal, calcium should be injected immediately when there is severe arrhythmia. Calcium ions only temporarily counteract the toxicity of potassium to the heart and do not reduce the concentration of potassium in the blood. Thus, they can only serve as a short-term emergency medication. (Medication should be used under the guidance of a doctor.)

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Written by Luo Han Ying

Endocrinology

1min 12sec

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What should not be eaten with hyperkalemia?

Potassium is an important element in human blood. Typically, the electrolytes we measure in blood tests include sodium, potassium, chloride, and calcium. Both low and high levels of potassium can have adverse effects on the body, especially hyperkalemia, which can cause sudden cardiac arrest and is considered dangerous in clinical settings. Patients with normal kidney function are less likely to develop hyperkalemia, which is more commonly seen in those who may have consumed Chinese herbal medicines containing high amounts of potassium for a long time. In patients with renal insufficiency, due to impaired kidney excretory function, hyperkalemia occurs more easily. Patients with hyperkalemia should generally avoid ACE inhibitors and ARB medications. For example, drugs like ACE inhibitors and spironolactone can further exacerbate hyperkalemia, so these types of medications are definitely not advisable. (The use of medications should be under the guidance of a professional doctor.)

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Written by Yang Li

Endocrinology

51sec

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What medication is used for hyperkalemia?

Hyperkalemia is primarily treated by promoting diuresis to enhance the elimination of potassium, while calcium gluconate can also be administered intravenously to counteract the inhibitory effects of potassium on the heart. Additionally, concentrated glucose with insulin can be used to shift excess potassium ions from the blood. Sodium bicarbonate can also be used to alkalinize the blood's pH to help reduce potassium levels. All these treatments must be conducted safely. In cases of severe hyperkalemia, dialysis may be necessary. If arrhythmias, bradycardia, or myocardial depression occur, the installation of a temporary pacemaker, along with hemodialysis, may be required. (Medication should be administered under the guidance of a physician.)

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Written by Wei Shi Liang

Intensive Care Unit

1min 18sec

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Common symptoms of hypokalemia and hyperkalemia

The common symptoms of hyperkalemia and hypokalemia, mainly seen in severe cases of high or low potassium, manifest as neurological and muscular symptoms as well as circulatory system symptoms, which are fairly similar in both conditions. If the blood potassium is particularly low, less than 2.0 mmol per liter, it can lead to reduced or absent reflexes. In severe cases, this may progress to paralysis of the respiratory muscles, causing respiratory pump failure. For hyperkalemia, particularly severe cases may also present with swallowing difficulties and respiratory distress. These central nervous system issues can lead to confusion and fainting. Another similar issue is the impact on the circulatory system; severe hypokalemia can cause ventricular tachycardia and even ventricular fibrillation, leading to death. In hyperkalemia, the impact on the cardiovascular system primarily causes malignant tachycardia and can also result in ventricular fibrillation. The main cause of sudden death in hyperkalemia is ventricular fibrillation and cardiac arrest, demonstrating that severe hyperkalemia and hypokalemia similarly cause significant arrhythmic conditions in the heart.

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Written by Wang Li Bing

Intensive Care Medicine Department

35sec

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Why is calcium used for hyperkalemia?

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

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.