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What causes a high potassium count?

Asked by Ruth Wheatley, Northern Kentucky

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How does one get a very high potassium count, and how do you lower it?

Expert Bio Picture

Living Well Expert Dr. Jennifer Shu Pediatrician,
Children's Medical Group

Expert answer

Having a high potassium level -- called hyperkalemia -- can be caused by poor kidney function resulting from conditions including renal failure, lupus, glomerulonephritis (an inflammation of the structures within the kidneys) or the effects of certain medications, such as some diuretics and medicines that lower blood pressure.

A diet that is high in potassium may also be the cause, although if a person's kidneys are working properly, the extra potassium is usually removed from the body through the urine. Items rich in potassium include bananas, salt substitutes and potassium supplements.

Lack of a hormone called aldosterone can also cause high potassium in the body. A disorder called Addison's disease is one example of this situation.

In addition, significant tissue breakdown from burns or trauma may release potassium from the cells of the body into the bloodstream.

The treatment of hyperkalemia depends in part of the severity of a person's symptoms and the cause of the condition. In many instances, there are no symptoms, and lowering the level may consist of avoiding excessive potassium intake, using a potassium-binding medication and treating any associated kidney problems.

Severe hyperkalemia can cause an abnormal heart rhythm, paralysis or irregular breathing patterns and may require aggressive intravenous medications to lower the potassium in the body quickly.

Sometimes, a high potassium count is the result of falsely elevated laboratory test, most frequently due to the rupture of red blood cells (called hemolysis) in the test sample either during or immediately after taking the blood. Hemolysis may occur due to rough handling during the blood draw or of the tube of blood before it is analyzed and does not accurately reflect the level of potassium in the body. Simply repeating the blood draw will most likely show a normal result.

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