How to treat vomiting caused by hyperkalemia?

Written by Gan Jun
Endocrinology
Updated on March 18, 2025
00:00
00:00

For patients with hyperkalemia, early symptoms include numbness in the limbs, weakness, muscle soreness, and paralysis. As the condition progresses, it can suppress myocardial function, reducing the tension of the myocardium and leading to slow heartbeats, and even cause arrhythmias and cardiac arrest. Increased release of acetylcholine can also cause nausea, vomiting, abdominal pain, and other symptoms. Patients with this condition generally also exhibit symptoms of hyperlipidemia and metabolic acidosis. For mild cases of hyperkalemia, temporary treatment may not be necessary, and symptomatic treatment such as stopping vomiting and drinking water may be sufficient. However, in acute cases, it is recommended that the patient immediately undergo dialysis or receive diuretic injections to rapidly eliminate potassium ions from the body, and to stop consuming foods and medications that contain potassium.

Other Voices

doctor image
home-news-image
Written by Wei Shi Liang
Intensive Care Unit
1min 12sec home-news-image

What kind of urine occurs with hyperkalemia?

Primary hyperkalemia often coincides with metabolic acidosis, and in hyperkalemia-induced metabolic acidosis, paradoxical alkaline urine can occur. Once hyperkalemia occurs, it primarily affects the conduction of the heart and neuromuscular system. Typical clinical manifestations include severe bradycardia, atrioventricular conduction block, and even sinus arrest. In mild hyperkalemia, the electrocardiogram shows peaked T-waves; as potassium levels continue to rise, the PR interval prolongs, T-waves disappear, QRS complex widens, and ultimately, cardiac arrest occurs. Immediate treatment should be administered upon diagnosis to promote the excretion of potassium, maximizing the renal excretion capacity with diuretics. If drug-induced potassium excretion does not normalize levels and serum potassium exceeds 6.5 mmol/L, hemodialysis may be necessary. Additionally, some drugs can be used to shift potassium into the cells and protect cardiac function. (The use of any medication should be under the guidance of a doctor.)

doctor image
home-news-image
Written by Wei Shi Liang
Intensive Care Unit
46sec home-news-image

What are the symptoms of hyperkalemia?

Mild hyperkalemia can affect muscle tissues, causing mild muscle tremors, while severe hyperkalemia may reduce the excitability of neuromuscular functions, leading to weakness and even flaccid paralysis in the limbs. Hyperkalemia can also impact the heart, mainly resulting in decreased myocardial excitability, decreased myocardial conductivity, and decreased myocardial automaticity. The effects on the electrocardiogram (ECG) primarily manifest as low and widened P waves, widened QS complexes, decreased R waves, and elevated T waves. Regarding myocardial contractility, hyperkalemia mainly causes a decrease in contractility and can lead to metabolic acidosis.

doctor image
home-news-image
Written by Wei Shi Liang
Intensive Care Unit
45sec home-news-image

Causes of Hyperkalemia

Common causes of hyperkalemia in clinical settings include: First, it is related to excessive intake. Generally, a high-potassium diet under normal kidney function does not cause hyperkalemia. It only occurs when there is excessive or rapid intravenous potassium supplementation, or when kidney function is impaired. Second, hyperkalemia caused by reduced excretion. Common reasons include renal failure, lack of adrenocortical hormones, and primary renal tubular potassium secretion disorders, all of which can cause hyperkalemia. Third, a large transfer of potassium ions from inside the cells to the outside can also cause hyperkalemia.

doctor image
home-news-image
Written by Chen Li Ping
Endocrinology
1min 13sec home-news-image

The Impact of Hyperkalemia on the Heart

Typically, when serum potassium exceeds 5.5 mmol/L, it is referred to as hyperkalemia. The manifestations of hyperkalemia on the cardiovascular system usually include bradycardia and arrhythmias, but generally do not lead to congestive heart failure. Sometimes, there may be cardiac enlargement and diminished heart sounds, with characteristic changes on an electrocardiogram. Finally, when serum potassium reaches 12 mmol/L, some parts of the myocardium may be excited and recover, while others have not yet depolarized, making it very easy to cause tachycardia, flutter, ventricular fibrillation, and even cardiac arrest, leading to death. Therefore, hyperkalemia is also a major cause of sudden cardiac death. Some patients with hyperkalemia may only exhibit arrhythmias and show no neuromuscular symptoms before death, thus a rapid diagnosis is crucial. The severity of hyperkalemia is generally assessed by both the measured serum potassium concentration and changes in the electrocardiogram.

doctor image
home-news-image
Written by Chen Li Ping
Endocrinology
58sec home-news-image

How is hyperkalemia treated?

For hyperkalemia, commonly used clinical treatments include firstly diuretics, which increase the excretion of potassium, thus increasing its discharge from the body. Additionally, hypertonic glucose with insulin is used intravenously to facilitate the movement of potassium from outside to inside the cells. Sodium bicarbonate can also be used to correct acidosis, which can likewise reduce blood potassium levels. When hyperkalemia causes ventricular arrhythmias, calcium injections should be administered immediately to counteract the cardiac toxicity of high potassium. If these treatments do not result in significant effects and the condition is critical, emergency hemodialysis or peritoneal dialysis can be performed to lower blood potassium levels. (Medication should be administered under the guidance of a doctor.)