Patients with skeletal muscle or cardiac manifestations typically have one or more of the characteristic ECG abnormalities associated with hyperkalemia. These manifestations usually occur when the serum potassium concentration is ≥7.0 mEq/L with chronic hyperkalemia or possibly at lower levels with an acute rise in serum potassium. (See "Causes and evaluation of hyperkalemia in adults" and "Treatment and prevention of hyperkalemia in adults".)ĬLINICAL MANIFESTATIONS - The most serious manifestations of hyperkalemia are muscle weakness or paralysis, cardiac conduction abnormalities, and cardiac arrhythmias. The causes, diagnosis, treatment, and prevention of hyperkalemia are discussed separately. The clinical manifestations of hyperkalemia will be reviewed here. (See "Diabetic ketoacidosis and hyperosmolar hyperglycemic state in adults: Treatment", section on 'Potassium replacement'.) Redistributive hyperkalemia most commonly occurs in uncontrolled hyperglycemia (eg, diabetic ketoacidosis or hyperosmolar hyperglycemic state). In some cases, the primary problem is movement of potassium out of the cells, even though the total body potassium may be reduced. Therapy for hyperkalemia due to potassium retention is ultimately aimed at inducing potassium loss. INTRODUCTION - Hyperkalemia is a common clinical problem that is most often due to impaired urinary potassium excretion due to acute or chronic kidney disease and/or disorders or drugs that inhibit the renin-angiotensin-aldosterone axis.
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