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Hyperkalemia is an elevated level of potassium (K +) in the blood. [1] Normal potassium levels are between 3.5 and 5.0 mmol/L (3.5 and 5.0 mEq/L) with levels above 5.5 mmol/L defined as hyperkalemia. [3] [4] Typically hyperkalemia does not cause symptoms. [1] Occasionally when severe it can cause palpitations, muscle pain, muscle weakness, or ...
Potassium binders are medications that bind potassium ions in the gastrointestinal tract, thereby preventing its intestinal absorption. This category formerly consisted solely of polystyrene sulfonate, a polyanionic resin attached to a cation, administered either orally or by retention enema to patients who are at risk of developing hyperkalaemia (abnormal high serum potassium levels).
A typical TTKG in a normal person on a normal diet is 8-9. During hyperkalemia or high potassium intake, more potassium should be excreted in the urine and the TTKG should be above 10. Low levels (<7) during hyperkalemia may indicate mineralocorticoid deficiency, especially if accompanied by hyponatremia and high urine Na.
Polystyrene sulfonate is usually supplied in either the sodium or calcium form. It is used as a potassium binder in acute and chronic kidney disease for people with hyperkalemia (an abnormally high blood serum potassium level). [3]
Hyperkalemia, particularly if severe, is a marker for an increased risk of death. [15] However, there is disagreement regarding whether a modestly elevated levels directly causes problems. One viewpoint is that mild to moderate hyperkalemia is a secondary effect that denotes underlying medical problems. [ 15 ]
Hyperkalemia usually does not develop until the glomerular filtration rate falls to less than 20–25 mL/min/1.73 m 2, when the kidneys have decreased ability to excrete potassium. Hyperkalemia in CKD can be exacerbated by acidemia (triggering the cells to release potassium into the bloodstream to neutralize the acid) and from lack of insulin. [26]
On their own this group of drugs may raise potassium levels beyond the normal range, termed hyperkalemia, which risks potentially fatal arrhythmias. Triamterene, specifically, is a potential nephrotoxin and up to half of the patients on it can have crystalluria or urinary casts .
Electrolyte disturbances are involved in many disease processes and are an important part of patient management in medicine. [ 1 ] [ 2 ] The causes, severity, treatment, and outcomes of these disturbances can differ greatly depending on the implicated electrolyte. [ 3 ]