Hyperkalemia: Effects of High Potassium on the Cardiovascular System, Kidneys and on the Body

The body needs to have a certain amount of potassium to survive. Potassium is a natural mineral and an electrolyte that the body needs for the muscles to work, including the muscles responsible for controlling your breathing and heartbeat. Generally, we get all the potassium we need from the food we eat, and the body uses whatever amount of potassium it needs. The excess potassium that the body does not need gets removed automatically from your bloodstream by the kidneys. However, in people with kidney disease, the kidneys are unable to remove the extra potassium in the correct manner. This means that too much of potassium can still remain in the bloodstream, a condition known as hyperkalemia or high potassium. Having too much potassium in the blood can be dangerous and even cause a heart attack or death. Let’s take a look at the various effects of high potassium on the body.

What is Hyperkalemia or High Potassium in the Blood?

Potassium is a mineral and an essential electrolyte that your body needs to function properly. Potassium has an important role to play in the functioning of your nerves and muscles, especially the heart.(1,2,3) However, while potassium is an essential mineral for your health, having too much of it can prove to be bad for your health, just as how having too little of it can also lead to adverse effects. Typically, your kidneys are responsible for maintaining a healthy balance of potassium in the body by flushing out the extra potassium out. But, for various reasons, sometimes the levels of potassium in the bloodstream can become too high. This condition is known as high potassium or hyperkalemia.(4,5,6)

A normal range of potassium in the blood is believed to be anywhere between 3.6 and 5.2 millimoles per liter (mmol/L). A potassium level that is higher than 5.5 mmol/L is said to be critically high while having a potassium level above 6 mmol/L is said to be life-threatening. Doctors do take into account some small variations in the ranges as each laboratory has a somewhat different calculation, though it does not vary by much.(7)

Regardless of whether you have mild or severely high potassium levels, it needs to be addressed immediately, and you must seek medical attention to prevent potential complications from arising. The symptoms of high potassium are often unnoticeable to most people, and you may only come to know that you have high potassium levels after getting some routine blood tests. The most common symptoms of hyperkalemia include:

Once diagnosed with a high potassium level, your doctor will monitor you more closely until your levels go back down to normal.

Here are some of the effects hyperkalemia has on the body.

Effect of High Potassium on the Cardiovascular System

The biggest impact of high potassium in the bloodstream is on the cardiovascular system. Too much potassium in the blood can cause heart problems such as arrhythmia or an irregular heartbeat. An arrhythmia can cause your heart to beat too slowly, too quickly, or not follow an even rhythm. Arrhythmias are commonly observed in people with hyperkalemia because potassium is needed for the proper functioning of the electric signaling in the myocardium. The myocardium is the thick muscle of the heart.(8,9)

Additionally, other symptoms of hyperkalemia that you experience may also be related to the cardiovascular system itself.

It is recommended that you seek immediate medical assistance if you experience any of the following symptoms:

All these could be an indication that there is a sudden spike in your blood potassium levels.

It is essential to keep in mind that certain medications you might be taking for heart conditions may also increase your potassium levels. If you have a heart-related problem or experienced heart failure, and you are on beta-blockers, diuretics, or ACE inhibitors, be aware that these drugs can lead to hyperkalemia.(10)

If you use these medications, your doctor is likely to keep monitoring your potassium levels regularly to avoid missing a diagnosis of hyperkalemia.

Effect of High Potassium on the Kidneys

High potassium levels do not directly cause kidney conditions, but they are nevertheless related to your kidneys. You become more vulnerable to high potassium if you have any type of kidney condition or kidney failure. This is because the kidneys are responsible for maintaining a balance of the potassium levels in the body.(11)

The body automatically absorbs potassium from foods, beverages, and sometimes even supplements. The kidneys flush out the excess potassium that is leftover through urine. However, if the kidneys themselves are not working properly, then your body is not able to remove or flush out the excess potassium, thus leading to a spike in potassium levels in the bloodstream.

Other Effects of High Potassium on the Body

High levels of potassium in the blood may also have other effects on the body. These includes:

  • Mood Changes: Hyperkalemia can cause sudden changes in your mood, causing you to especially feel irritated.
  • Shortness of Breath: While many people do not experience any symptoms, others complain of feeling shortness of breath with high levels of potassium.
  • Chest Pain: Many people experience chest pain due to high potassium. If you experience hyperkalemia, you need to seek immediate medical assistance.(12)
  • Abdominal Symptoms: High potassium can cause abdominal symptoms, which may cause nausea and/or vomiting. Diarrhea and abdominal cramping are also common. However, these are usually mild.
  • Muscle Weakness: High potassium in the blood can make you feel like you do not have any strength left in your body.
  • Tingling or Numbness: You may experience a tingling sensation that feels like pins and needles in your arms or feet. Numbness is also common and occurs in the arms, hands, feet, or legs.

These symptoms take time to develop and are usually so mild that it is unlikely you would even notice them. Such type of subtle signs is what makes it even more challenging to diagnose high potassium. This is why it is important to keep getting regular blood tests done so that the condition of hyperkalemia can be avoided.

Conclusion

If you are at risk of developing high potassium or you already have high potassium, it is important that you manage the condition in order to avoid any potential complications. For example, avoid having foods that are high in potassium, including citrus fruits and green leafy vegetables. You should consider consulting a dietitian or nutritionist to learn how to create a diet plan that restricts or avoids foods that are high in potassium while also maintaining your health and having a well-balanced diet. A diet that is low on potassium should also focus on the correct serving sizes to ensure that you are not consuming more potassium than you should be.

If your potassium levels are high, your doctor may prescribe medication to control the potassium levels, especially if you are unable to control the levels through diet alone. Remember that being dehydrated can make high potassium levels go up even more, so it is essential to drink plenty of water and stay well-hydrated.

References:

  1. Parham, W.A., Mehdirad, A.A., Biermann, K.M. and Fredman, C.S., 2006. Hyperkalemia revisited. Texas Heart Institute Journal, 33(1), p.40.
  2. Evans, K.J. and Greenberg, A., 2005. Hyperkalemia: a review. Journal of Intensive Care Medicine, 20(5), pp.272-290.
  3. He, F.J. and MacGregor, G.A., 2008. Beneficial effects of potassium on human health. Physiologia plantarum, 133(4), pp.725-735.
  4. He, F.J. and MacGregor, G.A., 2008. Beneficial effects of potassium on human health. Physiologia plantarum, 133(4), pp.725-735.
  5. Rowe, J.W., Tobin, J.D., Rosa, R.M. and Andres, R., 1980. Effect of experimental potassium deficiency on glucose and insulin metabolism. Metabolism, 29(6), pp.498-502.
  6. Holler, J.W., 1946. Potassium deficiency occurring during the treatment of diabetic acidosis. Journal of the American Medical Association, 131(15), pp.1186-1189.
  7. Ellis, K.J. and Shypailo, R.J., 1993. Whole body potassium measurements independent of body size. In Human Body Composition (pp. 371-375). Springer, Boston, MA.
  8. Tchervenkov, C.I., Wynands, J.E., Symes, J.F., Malcolm, I.D., Dobell, A.R. and Morin, J.E., 1983. Electrical behavior of the heart following high-potassium cardioplegia. The Annals of thoracic surgery, 36(3), pp.314-319.
  9. Poole-Wilson, P.A., 1984. Potassium and the heart. Clinics in endocrinology and metabolism, 13(2), pp.249-268.
  10. Legrand, M., Ludes, P.O., Massy, Z., Rossignol, P., Parenica, J., Park, J.J., Ishihara, S., AlHabib, K.F., Maggioni, A., Miro, O. and Sato, N., 2018. Association between hypo-and hyperkalemia and outcome in acute heart failure patients: the role of medications. Clinical Research in Cardiology, 107(3), pp.214-221.
  11. Hollander-Rodriguez, J.C. and Calvert, J.F., 2006. Hyperkalemia. American family physician, 73(2), pp.283-290.
  12. Yap, V., Patel, A. and Thomsen, J., 1976. Hyperkalemia with cardiac arrhythmia: Induction by salt substitutes, spironolactone, and azotemia. Jama, 236(24), pp.2775-2776.

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