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Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.

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Hyperkalemia laboratory findings

Introduction

Overview

Overview

In a patient who does not have a risk for hyperkalemia, repeating the blood test is indicated before taking any actions unless changes are present on electrocardiography

Laboratory Findings

Laboratory Findings

  • The first step in diagnosing hyperkalemia is to exclude pseudohyperkalemia by repeating the blood test.[1]
Grade Potassium level
Mild 5-6.0mEq/L
Moderate 6.1-7.2mEq/L
Severe >7.2mEq/L

Initial tests

  • Complete blood count (CBC)[2]
  • Metabolic profile .[3]
  • Urine potassium, sodium, and osmolality [4]
 
 
 
 
 
 
Hyperkalemia
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Exclude psuedohyperkalemia by repeating the blood test
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Acute rise in potassium
 
 
 
 
 
 
 
 
 
Persistent hyperkalemia
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Increase release of K+ from cells
Trauma,radiation therapy, DKA, metabolic acidosis
 
 
 
 
 
 
 
 
 
Decreased urinary excreation of K+
rule out aldosterone deficency
24 hr urine K+ excreation
 
 
 
 
 
 
 
 

Cause specific

Psudeohyperkalemia

  • Defined as the release of potassium from cells after their breakdown. Most commonly seen during blood collection, so it’s required to repeat blood test in patients with a transient rise in potassium without any risk factors.
  • Other causes include
    • Clotting increases release of potassium from platelets
    • In patients with the history of leukemia where the WBC count is >120,000/microL the potassium is raised to cell fragility
    • Hereditary (familial) forms of pseudohyperkalemia
References

References

  1. ↑ Lehnhardt A, Kemper MJ (2011). “Pathogenesis, diagnosis and management of hyperkalemia”. Pediatr Nephrol. 26 (3): 377–84. doi:10.1007/s00467-010-1699-3. PMC 3061004. PMID 21181208.
  2. ↑ Ingelfinger JR (2015). “A new era for the treatment of hyperkalemia?”. N Engl J Med. 372 (3): 275–7. doi:10.1056/NEJMe1414112. PMID 25415806.
  3. ↑ Kogika MM, de Morais HA (2017). “A Quick Reference on Hyperkalemia”. Vet. Clin. North Am. Small Anim. Pract. 47 (2): 223–228. doi:10.1016/j.cvsm.2016.10.009. PMID 27939860.
  4. ↑ Conte G, Dal Canton A, Imperatore P, De Nicola L, Gigliotti G, Pisanti N; et al. (1990). “Acute increase in plasma osmolality as a cause of hyperkalemia in patients with renal failure”. Kidney Int. 38 (2): 301–7. PMID 2402122.

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Priyamvada Singh, M.B.B.S. [2], Aditya Ganti M.B.B.S. [3]