Why is calcium used for hyperkalemia?

Written by Wang Li Bing

Intensive Care Medicine Department

Updated on September 20, 2024

00:00

00:00

Hyperkalemia can increase the excitability of myocardial cells, leading to various malignant arrhythmias and even sudden death. Immediate treatment is necessary after hyperkalemia occurs. Clinically, it can be treated by hemodialysis or conservatively with medication. Why use calcium preparations for hyperkalemia? Because after using calcium preparations, the excitability of myocardial cells can be stabilized, effectively maintaining stable heart rates in patients and preventing sudden death due to malignant arrhythmias.

Other Voices

home-news-image

Written by Wei Shi Liang

Intensive Care Unit

45sec

home-news-image

How to rescue hyperkalemia

Hyperkalemia must be dealt with immediately once it occurs. The usual treatments in clinical settings include promoting potassium excretion using furosemide or other loop diuretics to maximize renal potassium excretion, or using oral or rectal potassium-eliminating agents. For life-threatening hyperkalemia with serum potassium levels greater than 6.5 mmol/L, hemodialysis is necessary. Another approach is to facilitate the shift of potassium into cells, which is done through the administration of insulin with glucose, or sodium bicarbonate along with calcium gluconate that helps protect the myocardium, thus providing treatment and protective measures for hyperkalemia.

home-news-image

Written by Chen Li Ping

Endocrinology

1min 52sec

home-news-image

What are the causes of hyperkalemia?

The first reason is the excessive intake or administration of potassium, which can lead to hyperkalemia. For example, consuming foods that are very rich in potassium, or intravenously infusing solutions containing potassium. Additionally, the use of potassium salts of penicillin can also cause hyperkalemia, as well as the transfusion of stored blood, which can easily lead to hyperkalemia. Besides excessive intake and administration of potassium, diseases related to reduced excretion can also cause hyperkalemia, such as the most common instances during acute or chronic renal failure, where patients are prone to hyperkalemia. Furthermore, patients with reduced adrenal cortex function, such as aldosterone deficiency or Addison's disease, are also prone to hyperkalemia. Additionally, the use of diuretics that inhibit potassium excretion, notably spironolactone—a potassium-sparing diuretic—can also cause an increase in blood potassium levels. Another reason is a change in potassium distribution, such as when potassium moves from inside the cells to the outside, which can easily lead to hyperkalemia. This is common in cases of tissue damage, such as muscle contusion, or electrical burns, and tissue hypoxia, which also can easily lead to a change in potassium distribution, causing an increase in extracellular potassium. If hemolysis occurs in a test tube, such as if the venipuncture takes too long, or in conditions like leukocytosis or severe shaking of the blood sample, these might also lead to hyperkalemia. (The use of medications should be under the guidance of a doctor.)

home-news-image

Written by Wei Shi Liang

Intensive Care Unit

49sec

home-news-image

The role of calcium agents in hyperkalemia

Change the excitability of autonomic cells to protect the heart. Hyperkalemia mainly affects the conduction of the heart and neuromuscular system. Typical clinical manifestations include severe bradycardia, atrioventricular block, and even sinus arrest. By using calcium agents to change the excitability of autonomic cells, we can protect the heart from the damage to the conduction system caused by hyperkalemia. This allows the potassium ions to move from outside the cell to inside the cell. While protecting the myocardium, it is also necessary to use some medications to lower blood potassium. If the blood potassium is particularly high, dialysis or continuous bedside blood filtration can be used to reduce the blood potassium to a normal range.

home-news-image

Written by Wei Shi Liang

Intensive Care Unit

1min 2sec

home-news-image

The difference between hyperkalemia and hypokalemia

Potassium ions are one of the essential electrolytes necessary for human life. Their physiological functions include maintaining cell metabolism, regulating osmotic pressure and acid-base balance, and preserving cell emergency functions, among others. The normal concentration of serum potassium is between 3.5 and 5.5 millimoles per liter. If it falls below 3.5 millimoles per liter, it is categorized as hypokalemia. If it exceeds 5.5 millimoles per liter, it is categorized as hyperkalemia. Common causes of hypokalemia include insufficient potassium intake, excessive potassium excretion, and the shifting of potassium from outside to inside the cells. The main causes of hyperkalemia include increased intake or reduced excretion of potassium, as well as substantial movement of potassium from inside the cells to the outside. Whenever hyperkalemia or hypokalemia occurs, it should be actively managed.

home-news-image

Written by Wei Shi Liang

Intensive Care Unit

42sec

home-news-image

The effects of hyperkalemia on the body

Hyperkalemia affects the body mainly in three aspects. Firstly, hyperkalemia impacts muscle tissues, clinically manifesting as symptoms such as muscle tremors. Secondly, the effect of hyperkalemia on the heart primarily manifests as decreased excitability, conductivity, and automaticity of the myocardium. It affects electrocardiograms, characterized by a depressed P wave, widened QS wave, reduced R wave, and elevated T wave. Thirdly, hyperkalemia affects acid-base balance; during hyperkalemia, potassium efflux from cells can lead to metabolic acidosis, resulting in alkaline urine.