Mild hyperkalemia clinical manifestations

Written by Gan Jun

Endocrinology

Updated on November 01, 2024

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When blood potassium exceeds 5.5 millimoles per liter, it is referred to as hyperkalemia. Clinically, mild manifestations of hyperkalemia commonly involve the cardiovascular system, including bradycardia, audible enlargement of the heart, and weakened heart sounds. The electrocardiogram may show a shortened QT interval and peaked T waves. Symptoms related to the neuromuscular system include numbness in the lips and limbs, muscle soreness, and, in severe cases, paralysis of the respiratory muscles, which can lead to suffocation. All cases of hyperkalemia present various degrees of metabolic acidosis or azotemia, among other symptoms.

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Written by Wei Shi Liang

Intensive Care Unit

59sec

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Common Causes of Hyperkalemia

Hyperkalemia is when the serum potassium concentration exceeds 5.5 millimoles per liter. Common causes include excessive potassium intake and large doses of potassium salts, which can lead to hyperkalemia, as well as the use of stored blood. Another cause is reduced potassium excretion; in patients with renal insufficiency, reduced urine output or anuria leads to decreased renal potassium excretion. If potassium supplementation is inappropriate at this time, or if potassium-sparing diuretics are used, severe hyperkalemia can occur. Another scenario is the leakage of intracellular potassium during respiratory and metabolic acidosis, where sodium ion exchange occurs in cells, hydrogen ions enter the cells, and potassium ions leak out to the extracellular space, which can lead to increased blood potassium. These are the common causes of hyperkalemia.

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Written by Wei Shi Liang

Intensive Care Unit

46sec

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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.

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Written by Wang Li Bing

Intensive Care Medicine Department

42sec

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Treatment methods for hyperkalemia

In clinical practice, a blood potassium level greater than 5.5 millimoles per liter is referred to as hyperkalemia. Once hyperkalemia occurs, it must be actively managed: the first step is to stop using medications that increase blood potassium, such as sustained-release potassium chloride, potassium-sparing diuretics like spironolactone, and ACE inhibitors; the second step is to use calcium supplements to counteract the toxic effects of high potassium on the heart; the third step is to use hypertonic glucose with insulin and sodium bicarbonate to correct acidosis and promote the movement of potassium into the cells; the fourth step is to use the diuretic furosemide to help reduce blood potassium. If drug treatment is ineffective, bedside hemodialysis may be employed. (Use of the above medications should be under the guidance of a doctor.)

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Written by Wei Shi Liang

Intensive Care Unit

42sec

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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.

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Written by Gan Jun

Endocrinology

45sec

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Mild hyperkalemia clinical manifestations

When blood potassium exceeds 5.5 millimoles per liter, it is referred to as hyperkalemia. Clinically, mild manifestations of hyperkalemia commonly involve the cardiovascular system, including bradycardia, audible enlargement of the heart, and weakened heart sounds. The electrocardiogram may show a shortened QT interval and peaked T waves. Symptoms related to the neuromuscular system include numbness in the lips and limbs, muscle soreness, and, in severe cases, paralysis of the respiratory muscles, which can lead to suffocation. All cases of hyperkalemia present various degrees of metabolic acidosis or azotemia, among other symptoms.