POTASSIUM IMBALANCE

General Information

DEFINITION--Above (hyperkalemia) or below (hypokalemia) normal levels of potassium in the blood, body fluids and body cells. Potassium, along with sodium and calcium, maintains normal heart rhythm, regulates the body's water balance and is responsible for muscle contractions and nerve impulses.

BODY PARTS INVOLVED--Blood, which affects all body cells and body fluids.

SEX OR AGE MOST AFFECTED--Both sexes; all ages.

SIGNS & SYMPTOMS

Hyperkalemia:

• Weakness and paralysis.
• Dangerously rapid, irregular heartbeat or slow heartbeat (sometimes).
• Nausea and diarrhea.

Hypokalemia:

• Weakness and paralysis.
• Low blood pressure.
• Life-threatening rapid, irregular heartbeat. This is more severe than with hyperkalemia.

CAUSES

Hyperkalemia:

• Chronic kidney disease with kidney failure. Failing kidneys eliminate potassium too slowly, causing an excess in the body.
• Use of oral potassium supplements.
• Burns or crushing injuries. These may release potassium from body tissues into body fluids.
• Addison's disease.

Hypokalemia:

• The use of diuretic drugs for hypertension or heart failure.
• Prolonged loss of body fluids from vomiting or diarrhea.
• Chronic kidney disease with kidney failure. At certain stages, this may cause the body to lose potassium.

RISK INCREASES WITH

• Diabetes mellitus.
• Adrenal disease.
• Use of drugs, such as diuretics, ACE inhibitors, potassium supplements and digitalis. Low potassium levels especially in persons who take digitalis often lead to serious heartbeat disturbances.

HOW TO PREVENT

• If you have a disorder or take drugs that affect potassium levels (see Causes and Risks), learn as much as you can about your condition, your drugs and how you can prevent a potassium imbalance.
• If you take digitalis and diuretics, have frequent blood studies to monitor potassium levels.
• Obtain medical care for prolonged vomiting or diarrhea.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms, especially muscle weakness and heart-rhythm changes.
• Medical history and physical exam by a doctor.
• Laboratory blood and urine studies of potassium and other electrolytes.
• ECG (See Glossary).

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment.
• May be treatable at home with diet or potassium supplements, could require hospitalization for intravenous therapy (severe cases of either too much or too little potassium).

POSSIBLE COMPLICATIONS--Cardiac arrest and death.

PROBABLE OUTCOME--Usually can be corrected with treatment of the underlying disorder.

How To Treat

GENERAL MEASURES--

• If you take diuretics and digitalis, your friends and family members should learn cardiopulmonary resuscitation (CPR). Learn to count your own pulse at the wrist or neck.
• Don't take potassium supplements without your doctor' approval.

MEDICATION--Your doctor may prescribe:

• Oral potassium supplements to raise low levels.
• Diuretics to increase urination and decrease high potassium levels.
• Intravenous fluids to correct a serious imbalance.
• Medications appropriate for the underlying disease.

ACTIVITY--Resume your normal activities as soon as symptoms improve.

DIET--Depends on the condition. Mild hypokalemia can be corrected by increasing consumption of potassium-containing foods, such as orange juice, bananas, melon, carrots, tomato juice, papaya.

Call Your Doctor If

You have symptoms of a potassium imbalance or are having problems with a disorder that affects potassium levels.