An extensive literature review has been performed to present a comprehensive review of the causes and treatment of hyperkalemia. [ncbi.nlm.nih.gov]

• Fatigue

  It can cause: Muscle fatigue Weakness Paralysis Abnormal heart rhythms (arrhythmias) Nausea Jan. 11, 2018 References What is hyperkalemia? National Kidney Foundation. . Accessed Oct. 4, 2017. Potassium, serum. Mayo Medical Laboratories. . [mayoclinic.org]

  It can cause: Muscle fatigue Weakness Paralysis Abnormal heart rhythms (arrhythmias) Nausea Nov. 18, 2011 References Laboratory reference values. Potassium values. Rochester, Minn.: Mayo Foundation for Medical Education and Research. July 2011. [web.archive.org]

  We ask about general symptoms (anxious mood, depressed mood, fatigue, pain, and stress) regardless of condition. Last updated: January 30, 2019 [patientslikeme.com]

  Signs and symptoms Patients with hyperkalemia may be asymptomatic, or they may report the following symptoms (cardiac and neurologic symptoms predominate): Generalized fatigue Weakness Paresthesias Paralysis Palpitations Evaluation of vital signs is essential [emedicine.medscape.com]

• Nausea

  The patient presented with continuous tachycardia, palpitations, chest tightness, progressive nausea, irritability, progressive myasthenia gravis. Hyperkalemia, sepsis, acidosis, diabetes, postoperative esophageal cancer. [ncbi.nlm.nih.gov]

  It can cause: Muscle fatigue Weakness Paralysis Abnormal heart rhythms (arrhythmias) Nausea Jan. 11, 2018 References What is hyperkalemia? National Kidney Foundation. . Accessed Oct. 4, 2017. Potassium, serum. Mayo Medical Laboratories. . [mayoclinic.org]

  It can cause: Muscle fatigue Weakness Paralysis Abnormal heart rhythms (arrhythmias) Nausea Nov. 18, 2011 References Laboratory reference values. Potassium values. Rochester, Minn.: Mayo Foundation for Medical Education and Research. July 2011. [web.archive.org]

  It may cause abnormal heartbeats, irregular pulse and nausea. Hyperkalemia may result from alcoholism kidney disease and Addison’s disease. Treatment to reduce potassium levels includes diet modifications and the use of diuretics. [livestrong.com]

• Hypotension

  An 85 year-old woman on a drug regimen of sotalol, valsartan, spironolactone, and trimethoprim-sulfamethoxazole presented to the emergency department with hypotension and bradycardia. [ncbi.nlm.nih.gov]

  Amal Mattu’s ECG Case of the Week – January 21, 2019 HPI: A 50-year-old male is brought into the emergency department from prison with bradycardia, hypotension, and altered mental status. [ecgweekly.com]

  […] patient with hyperkalemia includes the following: A patient with known hyperkalemia or a patient with renal failure with suspected hyperkalemia should have intravenous access established and should be placed on a cardiac monitor [2] In the presence of hypotension [emedicine.medscape.com]

• Muscle Weakness

  Careful monitoring of electrocardiogram changes and muscle weakness in hyperkalemia is important to determine its functional consequences. If these are observed to be severe, immediate correction of hyperkalemia is essential. [acls.com]

  Signs and symptoms include muscle weakness, paralysis, hypothermia, and cardiac abnormalities (irregular conduction and arrhythmias). [visualdx.com]

  In most cases, this causes non-specific symptoms such as malaise, palpitations and muscle weakness and can only be detected with a blood test. [house.wikia.com]

  Sometimes people with hyperkalemia report nonspecific symptoms such as muscle weakness, tiredness, tingling sensations, or nausea. [emedicinehealth.com]

• Flaccid Paralysis

  In 94 patients, flaccid paralysis was described and in 25, severe muscular weakness; in 65 patients, these findings were associated with other symptoms. Concurrent renal failure was often documented. [ncbi.nlm.nih.gov]

  In severe cases, weakness and flaccid paralysis may occur. [fpnotebook.com]

  paralysis (diaphragm is usually spared) Loss of reflexes Normal cranial nerves Normal sensory function Cardiovascular effects Hypotension Bradycardia Biochemical abnormalities Normal anion gap metabolic acidosis (due to decreased renal ammoniagenesis [derangedphysiology.com]

• Paresthesia

  Signs and symptoms Patients with hyperkalemia may be asymptomatic, or they may report the following symptoms (cardiac and neurologic symptoms predominate): Generalized fatigue Weakness Paresthesias Paralysis Palpitations Evaluation of vital signs is essential [emedicine.medscape.com]

  Neuromuscular depolarization can also lead to poor action potentials, with accompanying paresthesias and weakness. return to top Signs, Symptoms, and Diagnosis history physical exam ECG changes lab investigations History A careful history, with emphasis [sharinginhealth.ca]

  No signs or symptoms are pathognomonic for this condition, although patients may rarely present with weakness or paresthesias. [saem.org]

• Absent Deep Tendon Reflex

  deep tendon reflexes When hyperkalemia is discovered, investigate potential pathophysiologic mechanisms. [emedicine.medscape.com]

• Asthenia

  The term myasthenia is from my- from Greek μυο meaning "muscle" -asthenia ἀσθένεια meaning "weakness". Types[edit] Neuromuscular fatigue can be classified as either "central" or "peripheral" depending on its cause. [en.wikipedia.org]

• Hyperreflexia

  And R – Reflexes, hyperreflexia or areflexia, they’re flaccid. So, MURDER, MURDER. Muscle Weakness, Urine, Respiratory Distress, Decreased Cardiac Contractility, EKG Changes and Reflexes. [nrsng.com]

See Workup for more detail. [emedicine.medscape.com]

• Left Axis Deviation

  Left axis deviation. Absent P waves. Example 6 Hyperkalaemia: Sine wave appearance with severe hyperkalaemia (K 9.9 mEq/L). Example 7 Hyperkalaemia: Huge peaked T waves. Sine wave appearance. [lifeinthefastlane.com]

• Wide QRS Complex

  Role of inducing K loss via the GI tract in the management of hyperkalemia Setting Recommendations Hyperkalemia with severe ECG changes (e.g. absent P waves, wide QRS complex) No role for inducing K loss via GI tract Moderately severe hyperkalemia with [doi.org]

• Potassium Increased

  RESULTS: We identified 132 incidences of hyperkalemia induced by 8413 potentially severe potassium-increasing DDIs among 76 467 patients. [ncbi.nlm.nih.gov]

  If serum potassium increases rapidly, cardiotoxicity will ensue. Reference: Rose BD, Post TW. Clinical Physiology of Acid-Base and Electrolyte Disorder, 5th ed, McGraw-Hill, New York, 2001, pp. 383-396, 898-910. Squires RD, Huth EJ. [acls.com]

  For every 0.1 unit decrease in blood PH, serum potassium increases by about 0.6 mmol/L (less if the acidosis is caused by organic acids) [2]. [escardio.org]

  This is also reflected in patients on peritoneal dialysis, with one study suggesting hyperkalemia 5.5 meq/L is associated with a heightened risk of death.43 Potassium increases during longer intradialytic intervals, and many have attempted to link these [jasn.asnjournals.org]

• Insulin Increased

  increases the uptake of potassium into the cells. [en.wikipedia.org]

• Prolonged PR Interval

  prolonged PR interval, wide QRS complex) as an alternative to 10 units of short acting insulin. [ncbi.nlm.nih.gov]

  Notes The classic ECG progression in hyperkalemia is: Peaked T waves Prolonged PR interval and flattening of the P wave Widening of the QRS Sine wave However. you cannot rely on the ECG to rule out significant hyperkalemia. [first10em.com]

  PR interval, prolonged QRS interval, loss of P wave, sine waves and finally ventricular fibrillation (see ECG guideline for normal values for age) ECG CHANGES DO NOT NECESSARILY PROGRESS IN ORDER OF SERIOUSNESS OR SEVERITY, IN RELATION TO THE SEVERITY [starship.org.nz]

  PR interval AV block sine wave ventricular fibrillation asystole However, the sensitivity of ECG changes is low, and severe elevation can be accompanied by a normal ECG. [sharinginhealth.ca]

  ECG Examples Example 1 This ECG displays many of the features of hyperkalaemia: Prolonged PR interval. Broad, bizarre QRS complexes — these merge with both the preceding P wave and subsequent T wave. Peaked T waves. [lifeinthefastlane.com]

• Sinus Arrest

  A surface 12-lead electrocardiogram presented sinus arrest with peaked T-wave. [escardio.org]

  The authors hypothesized that poor coding of arrhythmias associated with extremes of hyperkalemia, such as sinus arrest and asystole, led to this discrepancy. [jasn.asnjournals.org]

• Peaking T Wave

  They manifested similar initial symptoms (vomiting), abnormal serum potassium ( 8.0 mmol/L), and EKG's with peaked T waves. Both patients were treated for hyperkalemia and recovered without complication. [ncbi.nlm.nih.gov]

  A woman in her 40's was found down: Sinus rhythm with wide QRS at 133 ms and obvious Peaked T-waves with obvious hyperkalemia. But there is also significant ST elevation in V1-V3. Is there anterior STEMI? The K 8.1. [hqmeded-ecg.blogspot.com]

• Electrocardiogram Change

  Hemodialysis (HD) has been suggested as the definitive therapy for severe hyperkalemia in this population,although there is limited data regarding renal replacement options.We report a case of life-threatening hyperkalemia with electrocardiogram changes [ncbi.nlm.nih.gov]

  Common medications included β blockers, insulin, and aspirin; 80% had potassium Conclusions: Given the poor sensitivity and specificity of electrocardiogram changes, there is no support for their use in guiding treatment of stable patients. [cjasn.asnjournals.org]

  Treatments involve inducing potassium loss.6-8 Electrocardiogram changes in hyperkalemia include a tall peaked T wave. [acls.com]

  Acute treatments for hyperkalemia that is associated with electrocardiogram changes are well known, and include insulin and glucose, β-agonists, calcium and, if necessary, dialysis. [nature.com]

Food and Drug Administration approval for the treatment of hyperkalemia in October 2015. A second potassium-binding resin, a zirconium cyclosilicate currently known as ZS-9, may provide yet another alternative to the archetypal treatment with SPS. [ncbi.nlm.nih.gov]

Hyperkalemia Microchapters Home Patient information Overview Historical Perspective Classification Pathophysiology Causes Differentiating Hyperkalemia from other Diseases Epidemiology and Demographics Risk Factors Screening Natural history, Complications and Prognosis [wikidoc.org]

Prognosis The prognosis for specifically correcting hyperkalemia is excellent. However, hyperkalemia is usually caused by kidney failure, an often irreversible and eventually fatal condition. [medical-dictionary.thefreedictionary.com]

Outcomes The majority of patients have an excellent prognosis. [ncbi.nlm.nih.gov]

The physiopathologic association between the hyperkalemia and poor prognosis is complex and remains to be elucidated. [hindawi.com]

Although many causes of hyperkalemia exist, exogenous red blood cell transfusions are being recognized as the primary perioperative etiology. [ncbi.nlm.nih.gov]

This review article provides an overview of the physiology and the pathophysiology of potassium metabolism and hyperkalemia, the epidemiology of hyperkalemia, and its acute and chronic management. [ncbi.nlm.nih.gov]

Hyperkalemia Microchapters Home Patient information Overview Historical Perspective Classification Pathophysiology Causes Differentiating Hyperkalemia from other Diseases Epidemiology and Demographics Risk Factors Screening Natural history, Complications [wikidoc.org]

Genetic testing revealed mutations in two recently discovered genes, the study of which has helped to unravel the pathophysiologic pathways. [ncbi.nlm.nih.gov]

Hyperkalemia Microchapters Home Patient information Overview Historical Perspective Classification Pathophysiology Causes Differentiating Hyperkalemia from other Diseases Epidemiology and Demographics Risk Factors Screening Natural history, Complications [wikidoc.org]

Severe hyperkalemia is a medical emergency, which requires immediate therapies, followed by interventions aimed at preventing its recurrence. [ncbi.nlm.nih.gov]