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Dialysis Discussion => Dialysis: General Discussion => Topic started by: TynyOne on August 11, 2007, 02:37:22 PM

Title: Could someone please tell me.............
Post by: TynyOne on August 11, 2007, 02:37:22 PM
I was reading about Amanda's scary day (I hope I got her name right) and there were several times this word was mentioned and I do not know what it means, could someone please tell me what the word, hyperkalemia, means?  Does that just have something to do with diabetics?   I am sorry to even have to ask but I am still a "newbie" to this ESRD and I want to learn all I can.  Thanks in advance to everyone who can respond to me and please explain it in terms, I can understand!    LOL

Tammy
Title: Re: Could someone please tell me.............
Post by: Adam_W on August 11, 2007, 02:59:48 PM
Hyperkalemia is high potassium (I think - I've never actually had it).
Title: Re: Could someone please tell me.............
Post by: del on August 11, 2007, 04:35:33 PM
it is high potassium. Very dangerous!!
Title: Re: Could someone please tell me.............
Post by: okarol on August 11, 2007, 05:34:16 PM
Hyperkalemia

Alternative names   

High potassium; Potassium - high

Definition   

Hyperkalemia is a condition caused by higher than normal levels of potassium in the bloodstream.

Causes, incidence, and risk factors   

Potassium has many functions in the body. It helps to regulate the activity of all muscle tissue -- smooth muscles (such as the muscles in the intestines), the muscles of the heart, and skeletal muscles.

Potassium is part of the enzyme reactions in digestion and metabolism. It is also part of homeostasis, the mechanism that maintains a balance between the many electrical and chemical processes of the body.

Almost all (98%) potassium in the body is found inside the cells (intracellular). Only about 2% occurs in the fluids outside of the cells (extracellular). Potassium can move into and out of cells.

Blood tests reflect only the extracellular potassium levels, and do not indicate the amount of potassium within the cells. Movement of potassium into or out of cells can change the blood potassium level (serum potassium) when there is no change in the total amount of potassium in the body.

Hyperkalemia occurs when the level of potassium in the bloodstream is higher than normal. This may be related to increase in total body potassium or excessive release of potassium from the cells into the bloodstream.

The kidneys normally excrete excess potassium from the body. Therefore, most cases of hyperkalemia are caused by disorders that reduce the kidneys' ability to excrete potassium. Insufficient kidney function may result from disorders including (but not limited to):

Acute kidney failure
Chronic kidney failure
Lupus nephritis
Rejection of a kidney transplant
Obstructive uropathy
Glomerulonephritis
The hormone aldosterone (see the aldosterone test) regulates kidney excretion of sodium and potassium. Lack of aldosterone can result in hyperkalemia with an increase in total body potassium. Addison's disease is one disorder that causes reduced aldosterone production.

Any time potassium is released from the cells, it may accumulate in the extracellular fluid and the bloodstream. Acidosis (acidic condition of the body) results in movement of potassium from inside the cells to the extracellular fluid.

Tissue trauma causes the cells to release potassium into the extracellular fluid. This includes:

Traumatic injury
Surgery
Gastrointestinal bleeding
Tumors
Burns
Hemolytic conditions (disorders that cause blood cells to burst)
Rhabdomyolysis from drug ingestion, alcoholism, coma, or certain infections
If kidney function is adequate, and sufficient amounts of aldosterone are present, tissue trauma alone rarely results in hyperkalemia. A normally functioning kidney will excrete the excess potassium that has been released from the cells.

Increased intake of potassium may cause hyperkalemia if kidney function is poor. Salt substitutes often contain potassium, as do many "low-salt" packaged foods. Hyperkalemia may be caused by medications, including medications that affect kidney function (potassium sparing diuretics, such as spironolactone, amiloride, or triamterene) and potassium supplements (especially intravenous potassium).

Hyperkalemia can have serious, potentially life-threatening effects on the body. A gradual increase in potassium, as may occur with chronic renal failure, may be better tolerated than a sudden increase. Slightly higher than normal potassium levels may be well tolerated by some persons with chronic renal failure.

Symptoms   

Hyperkalemia often has no symptoms. Occasionally, the following signs or symptoms may be seen:

Nausea
Irregular heartbeat (this may be an emergency symptom if prolonged or severe)
Slow, weak, or absent pulse (emergency symptom)
Signs and tests    Return to top

The pulse may be slow or irregular.
Serum potassium is high.
ECG may show potentially lethal arrhythmias:
Bradycardia (slower-than-normal heart beat) that progressively slows.
Heart block that may become complete heart block.
Ventricular fibrillation.
ECG may show changes indicative of hyperkalemia.
Treatment   

Cardiac arrest (absent heartbeat) may occur at any time during treatment of hyperkalemia. Hospitalization and close monitoring is required.

ACUTE TREATMENT

The goal of acute treatment is to protect the body from the effects of hyperkalemia. This may include protective measures, shift of potassium into the intracellular fluid, and reduction of total body potassium.

Emergency treatment is indicated if the potassium is very high, or if severe symptoms are present, including changes in the ECG.

Intravenous calcium may be given to temporarily counteract the muscle and heart effects of hyperkalemia, including cardiac arrhythmias (irregular heart beats). Intravenous (given in the vein) calcium will only counteract symptoms for about 1 hour, so other treatments should begin immediately.

Intravenous glucose and insulin moves potassium from the extracellular fluids back into the cells. This may reverse severe symptoms long enough to allow correction of the cause of the hyperkalemia.

Sodium bicarbonate causes potassium to shift from extracellular to intracellular fluids. It may reverse hyperkalemia caused by acidosis with no other treatment required. Prolonged use of sodium bicarbonate should be avoided because it may cause severe complications.

Diuretic medications (water pills) cause decrease in total body potassium. They may be prescribed for people who can tolerate the loss of body fluid that accompanies use of a diuretic.

Cation-exchange resins, such as sodium polystyrene sulfonate (Kayexalate), are medications that bind (attach to) potassium and cause it to be excreted from the gastrointestinal tract. These medications may be given orally or rectally.

Dialysis may be used to reduce total body potassium levels, especially if kidney function is compromised. Dialysis is indicated when more conservative measures have failed or are inappropriate.

LONG-TERM TREATMENT

Long-term treatment includes treatment of the cause and associated disorders.

Treatment of chronic renal failure may include dietary potassium restriction. "Loop diuretics" may be prescribed to reduce potassium and fluid levels in persons with chronic renal failure.

Need for potassium supplements and other medications that may cause hyperkalemia should be reviewed by the health care provider. These medications may be stopped, reduced in dose, or substituted by another medication.

Salt substitute, often used by people on a low salt diet, should not be used by those with renal failure or a history of hyperkalemia.

Expectations (prognosis)   

The probable outcome is variable. The disorder may cause deadly complications, or it may be well tolerated by the body.

Complications   

Changes in neuromuscular control
Arrhythmias
Cardiac arrest
Calling your health care provider   

Go to the emergency room or call the local emergency number (such as 911) if symptoms indicating hyperkalemia are present. Emergency symptoms include loss of consciousness, changes in breathing pattern, nausea, weakness and absent or weak heartbeat.

Prevention   

Disorders that may cause hyperkalemia should be treated promptly. Serum potassium should be monitored in persons with these conditions.

Kidney function should be assessed prior to and during administration of potassium supplements. They should not be given unless the urine output and kidney function is adequate.

http://www.nlm.nih.gov/medlineplus/ency/article/001179.htm
Title: Re: Could someone please tell me.............
Post by: angela515 on August 11, 2007, 08:33:49 PM
Yup, High Potassium... I guess i;m fortunate to never feel the symptoms b/c I have had plenty of times my Potassium was 6.0 and higher.
Title: Re: Could someone please tell me.............
Post by: Earlinda on August 11, 2007, 08:38:19 PM
Thank you Okarol for the excellent information.  I had questions about what Amanda went through too and you answered them all.  You are so awesome!   :yahoo;

Earlinda
Title: Re: Could someone please tell me.............
Post by: Rerun on August 12, 2007, 08:21:39 AM
I make them put me on 1K.  This bull-shit about nagging me about HIGH potassium all the time got to me.  1K and I'm fine.
Title: Re: Could someone please tell me.............
Post by: TynyOne on August 12, 2007, 05:33:33 PM
Thanks to everyone for their responses, I greatly appreciate it.   I noticed that the article mentioned the medicine sodium bicarb and I am on that medication but that article said it is not for long term use, I wonder what is considered "long term use"?  I guess I will ask my kidney doc the next time I see him.  Thanks again to everyone for your response.

Tammy
Title: Re: Could someone please tell me.............
Post by: Rerun on August 13, 2007, 10:31:24 PM
I make them put me on 1K.  This bull-poo about nagging me about HIGH potassium all the time got to me.  1K and I'm fine.

WTF?  I can't say "Bull-s h i t" on this site?  Who put bull "poo"?  What mod changed my post!  Why don't I see a "last modified by?"

I want an answer! 
Title: Re: Could someone please tell me.............
Post by: Rerun on August 13, 2007, 10:37:48 PM
OK OK there is an autimatic change when I write s h i t  it turns to poo.  Shit  see?? 

What is doing this?  It is not Epoman unless he is an angel now. 
Title: Re: Could someone please tell me.............
Post by: okarol on August 13, 2007, 11:07:33 PM
You're kidding??? If I write shit it no longer says shit? Come on!!
WHOA!! That is too freaky!
Epoman has the final word - and it ain't shit (I wrote S H I T everytime.)
Title: Re: Could someone please tell me.............
Post by: tamara on August 14, 2007, 12:23:57 AM
that's enough to give you the S H I T S  :banghead;  ;)
Title: Re: Could someone please tell me.............
Post by: Ken Shelmerdine on August 14, 2007, 08:38:00 AM
 Studies have shown that Hyperkalemia can also be caused by ACE inhibitor bloodpressure drugs such as Analapril  and Ramapril and also Angio-Retensin blockers such as Candesarten.
Title: Re: Could someone please tell me.............
Post by: pdpatty on August 14, 2007, 06:52:35 PM
Could lisinopril cause it too? I am taking 40mg lisinopril and my potassium keeps cliimbing. It was 5.5 this last blood test. That was a .5 increase from previous test. I try to avoid all high potassium foods.
Think I will ask about including lasix back.I always had very low potassium before hemo. It never went above 3.2-3.4.
Title: Re: Could someone please tell me.............
Post by: Ken Shelmerdine on August 17, 2007, 05:31:04 AM
Could lisinopril cause it too? I am taking 40mg lisinopril and my potassium keeps cliimbing. It was 5.5 this last blood test. That was a .5 increase from previous test. I try to avoid all high potassium foods.
Think I will ask about including lasix back.I always had very low potassium before hemo. It never went above 3.2-3.4.

Yes. Lisinopril is an ace inhibitor like analapril and ramipril. If you have only been taking Lisinpril since starting Haemo then I think it's more than coincidence that your potassium went up at the same time.
Title: Re: Could someone please tell me.............
Post by: goofynina on August 17, 2007, 12:10:11 PM
I make them put me on 1K.  This bull-poo about nagging me about HIGH potassium all the time got to me.  1K and I'm fine.

WTF?  I can't say "Bull-s h i t" on this site?  Who put bull "poo"?  What mod changed my post!  Why don't I see a "last modified by?"

I want an answer! 

This problem has been resolved and we can all go back to "shitting" now,  :oops;
Title: Re: Could someone please tell me.............
Post by: LightLizard on August 17, 2007, 01:37:26 PM
oh POO! i just washed my hands, too.
 :rofl;
Title: Re: Could someone please tell me.............
Post by: okarol on August 17, 2007, 06:42:05 PM
oh POO! i just washed my hands, too.
 :rofl;

funny  ;D
Title: Re: Could someone please tell me.............
Post by: Ken Shelmerdine on August 19, 2007, 09:27:50 AM
SHIT SHIT SHIT SHIT--Just testing!
Title: Re: Could someone please tell me.............
Post by: Jill D. on August 19, 2007, 12:44:56 PM
This thread about high potassium is very serious and informative....but I must admit that the shit about shit has me cracking up!!! :lol;
Title: Re: Could someone please tell me.............
Post by: kitkatz on August 21, 2007, 11:50:23 PM
Why were Tiger and Piglet looking in the toilet?






They were looking for Pooh!
Title: Re: Could someone please tell me.............
Post by: Ken Shelmerdine on August 23, 2007, 08:27:34 AM
 Boilogy teacher said to boy who was embarrassed to say the word 'penis'

'It's penis boy! this is biology we don't beat about the bush we say the word! And which book are you reading at the moment boy!

Boy replied 'Whinnie the SHIT.....sir