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U&E: a repeat U&E sample should be sent.

Relevant laboratory investigations include: Progression of ECG changes in hyperkalaemia DKA)Īn ECG is an essential investigation in the context of hyperkalaemia.

Capillary blood glucose: to exclude hyperglycaemia (e.g.

hyperkalaemic renal tubular acidosis or DKA) and rapidly check serum potassium

Blood gas ( venous or arterial): to exclude metabolic acidosis (e.g.

12-lead ECG: to identify ECG changes which suggest cardiotoxicity.A venous blood gas can be used to rapidly confirm hyperkalaemia. The first consideration is whether this could be pseudohyperkalaemia (e.g. Serum potassium is reported as part of urea & electrolytes (U&Es). Bradycardia secondary to hyperkalaemia-induced atrioventricular block.In most cases, there are no obvious clinical signs of hyperkalaemia.

Patients may sometimes experience palpitations, chest pain or shortness of breath. Symptoms of hyperkalaemia are typically vague and include general weakness and fatigue. If there are concerns about pseudohyperkalaemia, a sample should be urgently repeated to check the validity of the result. Blood sample being taken from a limb receiving IV fluids containing potassium.prolonged tourniquet time, prolonged sample transport time, use of incorrect blood bottles) Pseudohyperkalaemia can occur for a wide variety of reasons, including:

In Addison’s disease, the adrenal glands cannot produce adequate aldosterone levels, which results in reduced renal excretion of potassium. Addison’s diseaseĪldosterone promotes the excretion of potassium by the kidneys. In diabetic ketoacidosis (DKA), potassium shifts from the intracellular to the extracellular space due to a lack of insulin, resulting in hyperkalaemia. Tissue damage sustained secondary to trauma or burns results in the release of significant volumes of potassium from damaged cells. Intravenous fluids containing potassium also have the potential to cause hyperkalaemia when prescribed inappropriately.īlood transfusion is another potential cause of hyperkalaemia.

Beta-blockers – selective and non-selective can cause it.

Many medications can cause or contribute to hyperkalemia directly or indirectly: As a result, renal impairment is one of the commonest causes of hyperkalaemia. The kidneys are responsible for 90% of potassium excretion in healthy individuals, with the remainder excreted via the gastrointestinal tract. You might also be interested in our medical flashcard collection which contains over 1000 flashcards that cover key medical topics.