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Hyperkalemia

Hyperkalemia occurs when the potassium levels in your blood are too high. Very high potassium levels can cause problems with your heart, kidneys, and muscles. High potassium can be caused by diet, illness, medications, or kidney problems.

The experts at UPMC can help you find the cause of your high potassium levels, develop a treatment plan, and monitor your condition over time if needed.

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What Is Hyperkalemia?

Potassium is an electrolyte, or mineral, that you get from food. It helps your body function properly. Your kidneys help to regulate the amount of potassium in your blood.

Hyperkalemia occurs when the potassium levels in the blood are too high. Very high potassium levels can damage the heart, kidneys, and muscles.

Is hyperkalemia life-threatening?

Mild, temporary cases of hyperkalemia are not usually life-threatening. However, severe hyperkalemia that lasts a long time can cause serious heart problems, such as heart palpitations, heart attack, abnormal pulse, and sudden cardiac arrest.

What are the severity types of hyperkalemia? 

There are three severity levels of hyperkalemia based on the amount of potassium in your blood. The normal range for potassium levels in an adult is 3.5-5.4 mEq/L.

Severity levels of hyperkalemia include:

  • Mild hyperkalemia — Blood potassium levels of 5.5-6.0 mEq/L.
  • Moderate hyperkalemia — Blood potassium levels of 6.1-7.0 mEq/L.
  • Severe hyperkalemia — Blood potassium levels of more than 7.0 mEq/L.

What causes hyperkalemia?

Hyperkalemia can be caused by diet, illness, medications, or kidney problems, including:

  • Bleeding from your stomach or intestines.
  • Blood disorders, such as hemolytic anemia.
  • Diabetes that is not well-controlled.
  • Medications, such as blood pressure medications or potassium supplements.
  • Hormonal disorders, such as Addison’s disease.
  • Kidney disease.
  • Severe burns that affect a large body area or other severe injuries.
  • Tumors.

What is the main cause of hyperkalemia?

The most common cause of hyperkalemia is kidney disease, such as chronic kidney disease, acute kidney injury, or kidney failure.

What are hyperkalemia risk factors and complications?

Hyperkalemia risk factors

You may be at increased risk of hyperkalemia if you:

  • Have kidney disease or receive dialysis for kidney failure.
  • Eat a lot of high-potassium foods, especially if you have kidney disease.
  • Have diabetes.
  • Have chronic constipation.
  • Take certain blood pressure medications.
  • Take potassium supplements.
  • Use salt substitutes that contain potassium.

Complications of hyperkalemia

If left untreated, hyperkalemia can cause serious — and sometimes life-threatening — complications, including:

How can I prevent hyperkalemia? 

Hyperkalemia isn’t always preventable.

However, you may be able to lower your risk for hyperkalemia by:

  • Avoiding salt substitutes.
  • Changing the doses of medications that may cause high potassium.
  • Limiting foods that are high in potassium, such as asparagus, avocados, bananas, cantaloupes, cooked spinach, honeydew, kiwifruit, nectarines, oranges, orange juice, prunes, pumpkin, tomatoes and tomato products, and winter squash.
  • Reducing or stopping potassium supplements.

How common is hyperkalemia?

Hyperkalemia is rare in the general population, but it is more common in people with kidney disease. More than 50% of people with chronic kidney disease develop high potassium levels at some point. 

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What Are the Signs and Symptoms of Hyperkalemia?

Mild cases of hyperkalemia may not cause noticeable symptoms. Mild symptoms may develop over weeks or months and may include:

  • Abdominal pain.
  • Diarrhea.
  • Fatigue.
  • Muscle weakness.
  • Nausea.
  • Numbness and tingling in your hands and feet.

 More severe cases may cause:

  • Abnormal heart rhythm.
  • Chest pain or pressure.
  • Irregular pulse.
  • Nausea or vomiting.
  • Shortness of breath.
  • Sudden collapse from cardiac arrest.

When should I see a doctor about my hyperkalemia symptoms?

If you are having mild symptoms of hyperkalemia, you should schedule an appointment with your doctor right away. Early diagnosis and treatment can lower your risk of serious complications.

If you are having severe heart-related symptoms, such as chest pain or pressure, abnormal heart rhythms, or shortness of breath, you should dial 911.

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How Do You Diagnose Hyperkalemia?

Hyperkalemia is usually diagnosed with a blood test to check your potassium level.

What to expect during your visit

During your visit, your doctor will:

  • Ask about any medications you’ve taken recently.
  • Order blood tests.
  • Perform a physical exam.
  • Review your health history.

Tests to diagnose hyperkalemia

Blood tests

Your doctor will order a blood test to check your potassium level. Because other hormones and minerals can affect your potassium level, your doctor may also order other blood tests to check your levels of:

  • Glucose.
  • Minerals, such as magnesium, calcium, sodium, or phosphorus.
  • Hormones produced by the thyroid and adrenal glands.

Other tests

Your doctor may order an electrocardiogram (ECG or EKG) to check for abnormal heart rhythms. An EKG is a simple and fast outpatient diagnostic procedure that evaluates the electrical system of your heart.

Hyperkalemia prognosis

With medical treatment and ongoing monitoring, most people can recover from or manage hyperkalemia.

How do you fix high potassium?

If your hyperkalemia is mild and caused by a temporary health issue, you may only need treatment for a few days or weeks. If your hyperkalemia is severe and due to a chronic condition, such as kidney disease, uncontrolled diabetes, or long-term medication use, you may need ongoing treatment.

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How Do You Treat Hyperkalemia?

Most cases of hyperkalemia need to be treated by a doctor. Reducing the amount of potassium in your diet is usually not enough to treat hyperkalemia.

Your doctor may recommend:

Emergency hyperkalemia treatment

You may need emergency treatment for hyperkalemia if your potassium levels are very high or you are having heart-related symptoms.

Emergency treatment may include:

  • Intravenous (IV) medications — Glucose or insulin given by IV may help to lower potassium levels or treat symptoms. Calcium IV may stabilize heart membranes to decrease the risk of arrhythmia if there are EKG changes.
  • Medications — Potassium binders, diuretics, and other medications may be used to lower potassium levels.
  • Kidney dialysis — Dialysis helps to clean and filter excess potassium from your blood. Dialysis is a late-stage treatment.

Medication changes

Your doctor may recommend medication changes to treat hyperkalemia or lower the risk of future recurrences, including:

  • Lowering the dose or stopping potassium supplements.
  • Changing the dose of blood pressure medications that may be contributing to high potassium levels.
  • Prescribing medication to bind potassium in the gastrointestinal tract.
  • Taking a different type of diuretic to lower potassium and fluid levels.

Lifestyle changes

Although decreasing potassium levels in your diet is usually not enough to treat hyperkalemia after it develops, it may help prevent future recurrences. Your doctor or a registered dietitian may recommend avoiding potassium-rich foods and salt substitutes.

Why choose UPMC for hyperkalemia care?

When you choose UPMC for hyperkalemia care, you will receive:

  • Access to world-class nephrology expertise — Our world-renowned experts treat the full spectrum of kidney and related diseases using the latest techniques for diagnosis and treatment.
  • Advanced diagnostic care — We’ll find the cause of your illness and work with you to develop a comprehensive treatment plan.
  • A full range of treatment options — We offer comprehensive care tailored to your individual needs.

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By UPMC Editorial Staff. Last reviewed on 2025-04-24 by Alexandra Bursic, MD.