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

Signs of trauma may indicate that the patient has rhabdomyolysis, which is one cause of hyperkalemia See Clinical Presentation for more detail. [emedicine.com]

• Fatigue

  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 can cause: Muscle fatigue Weakness Paralysis Abnormal heart rhythms (arrhythmias) Nausea Jan. 11, 2018 References What is hyperkalemia? National Kidney Foundation. https://www.kidney.org/atoz/content/what-hyperkalemia. Accessed Oct. 4, 2017. [mayoclinic.org]

  Central muscle fatigue manifests as an overall sense of energy deprivation, while peripheral muscle fatigue manifests as a local, muscle-specific inability to do work.[1][2] Neuromuscular fatigue[edit] Nerves control the contraction of muscles by determining [en.wikipedia.org]

  Resultant decreases in intracellular [K+] and increases in interstitial [K+] in contracting skeletal muscle have been implicated in the fatigue process. [ncbi.nlm.nih.gov]

  We ask about general symptoms (anxious mood, depressed mood, fatigue, pain, and stress) regardless of condition. Last updated: January 30, 2019 [patientslikeme.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 Nov. 18, 2011 References Laboratory reference values. Potassium values. Rochester, Minn.: Mayo Foundation for Medical Education and Research. July 2011. [web.archive.org]

  It can cause: Muscle fatigue Weakness Paralysis Abnormal heart rhythms (arrhythmias) Nausea Jan. 11, 2018 References What is hyperkalemia? National Kidney Foundation. https://www.kidney.org/atoz/content/what-hyperkalemia. Accessed Oct. 4, 2017. [mayoclinic.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]

  It can also cause urinary sodium wasting, leading to volume depletion and hypotension. [en.wikipedia.org]

  […] toxicity Clinical Features of Hyperkalemia History and examination findings Neurological effects Paraesthesia Weakness and flaccid paralysis (diaphragm is usually spared) Loss of reflexes Normal cranial nerves Normal sensory function Cardiovascular effects Hypotension [derangedphysiology.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.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 severe cases, weakness and flaccid paralysis may occur. [icd9data.com]

  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]

  Fluoride toxicity Clinical Features of Hyperkalemia History and examination findings Neurological effects Paraesthesia Weakness and flaccid paralysis (diaphragm is usually spared) Loss of reflexes Normal cranial nerves Normal sensory function Cardiovascular [derangedphysiology.com]

• Paresthesia

  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]

  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.com]

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

• Absent Deep Tendon Reflexes

  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.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]

• Potassium Increased

  OBJECTIVE: To compare different strategies predicting hyperkalemia (serum potassium level ≥5.5 mEq/l) in hospitalized patients for whom medications triggering potassium-increasing drug-drug interactions (DDIs) were ordered. [ncbi.nlm.nih.gov]

  Increased urinary loses – potassium excretion occurs mostly in the distal nephrons and increased losses may be seen in diuretic use, increased aldosterone secretion, nonreabsorbable anions, and loss of gastric secretions. [acls.com]

  Increase in the intake of potassium via any route, e.g., dietary oral intake, or intravenous administration of potassium containing fluids like penicillin G. [escardio.org]

  increase in mortality with one, two, and three or more potassium measurements >5.0 meq/L, respectively) and maximum achieved serum potassium level (4.2%, 11.1%, 16.6%, 26.6%, and 31.7% increase in mortality with potassium levels <5.0, 5.0–5.5, 5.5–6.0 [jasn.asnjournals.org]

• Insulin Increased

  The insulin is usually given with an appropriate amount of glucose to prevent hypoglycemia following the insulin administration. Salbutamol (albuterol), a β2-selective catecholamine, is administered by nebuliser (e.g. 10–20 mg). [en.wikipedia.org]

• 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 [doi.org]

• Prolonged PR Interval

  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]

  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]

  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]

• 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

  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]

  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]

  At higher levels of potassium (< 8.0 mmol/L), the ECG may demonstrate peaked T waves, PR prolongation with decreased P waves, and widening QRS. [visualdx.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]

  Coincident, baseline, and follow-up electrocardiograms were examined for quantitative and qualitative changes in the QRS and T waves as well as the official cardiology readings. [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]

[…] from iMedicalApps review "The best free Medical Calculator apps" 'Calculate' is focused on highlighting tools which are actually useful in clinical practice and serve to impact diagnosis, treatment or determining prognosis. [play.google.com]

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

The review includes a discussion of potassium homeostasis and the etiologies of hyperkalemia and focuses on the prompt recognition and treatment of hyperkalemia. [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]

Definition: A serum potassium level > 5.5 mEq/L Epidemiology Common electrolyte disorder 10% of hospitalized patients ( Elliott 2010 ) Causes Pseudohyperkalemia: extravascular hemolysis Renal failure (potassium is primarily eliminated by the kidneys) [coreem.net]

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

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

Usually, hyperkalemia results from several simultaneous problems, including the following: Kidney disorders that prevent the kidneys from excreting enough potassium Drugs that prevent the kidneys from excreting normal amounts of potassium (a common cause [msdmanuals.com]