Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Hyperkalemia is an excessive level of potassium in the
bloodstream. Potassium has several important functions in the body. It is
essential for the normal functioning of the muscles, heart, and nerves.
Potassium helps the body regulate activity of muscle, including the smooth muscle
(involuntary muscles, such as
the muscles found in the digestive tract), skeletal muscle
(voluntary muscles,
such as muscles of the extremities and torso), and the muscle of the heart. It
is also important for maintaining normal heart electrical rhythm and for normal
electrical signals in the nervous system.
The normal potassium level in the blood is 3.5-5.0 milliEquivalents per liter
(mEq/L).
Potassium levels between 5.1 mEq/L to 6.0 mEq/L are considered to be
mild hyperkalemia.
Potassium levels of 6.1 mEq/L to 7.0 mEq/L are moderate
hyperkalemia, and levels above 7 mEq/L reflect severe hyperkalemia.
Hyperkalemia Causes
Excess potassium in the bloodstream can result from diseases of the kidneys
or adrenal glands as well as from certain medications. Hyperkalemia can also be
the result of potassium moving out of its usual location within cells into the
bloodstream.
The majority of potassium within the body (about 98%) is
located within cells, with only 2% located in the bloodstream. A number of
conditions can cause potassium to move out of the cells into the blood
circulation, thereby
increasing the measured level of potassium in the blood, even though the total
amount of potassium in the body has not changed. Diabetic ketoacidosis, an
emergency that can develop in people with
type I diabetes, is an example of a
condition in which potassium is drawn out of cells and into the bloodstream.
Similarly, any condition in which there is massive tissue destruction can
result in elevated levels of blood potassium as the damaged cells release their
potassium. Examples of tissue destruction include:
rhabdomyolysis (a condition involving destruction of muscle cells that is
sometimes associated with muscle injury,
alcoholism, or
drug abuse).
Moreover, difficulty in drawing
blood from veins for testing can traumatize red blood cells, releasing potassium
into the serum of the blood sample to cause a falsely elevated reading of
hyperkalemia on the blood test.
Any condition that decreases kidney function can result
in hyperkalemia, since the kidneys rid the body of excess potassium by excreting
it in the urine. Examples of conditions that decrease kidney function are
glomerulonephritis, acute or
chronic renal failure, transplant rejection,
and obstructions within the urinary tract (such as the presence of stones).
The adrenal glands secrete many hormones important for proper body function.
Among these is aldosterone, which regulates the retention of sodium and fluid in
the kidneys along with the excretion of potassium in the urine. Diseases of the
adrenal gland (such as Addison's disease, that causes a decreased aldosterone
secretion) lead to a decrease in kidney excretion of potassium resulting in
hyperkalemia.
Examples of medications that may lead to elevated
potassium levels include:
Vomiting and nausea are not illnesses but common symptoms that accompany with many diseases and conditions. The problems with nausea and vomiting are related to the cause. Nausea and vomiting from motion sickness, seasickness,
food poisoning, or cancer therapy can result in loss of water and electrolytes, which can lead to
dehydration. Vomiting and nausea known as
morning sickness may occur during pregnancy.
Nausea is an unpleasant, queasy feeling in the throat or stomach that may result in vomiting.
Vomiting is emptying the stomach as a result of strong gagging and retching that leads to throwing up. The stomach's contents are forcefully expelled through the mouth. Vomiting can come in waves as the natural movement (muscle
contractions of the digestive system known as peristalses) is reversed, and involuntary contractions in the walls of
the stomach and esophagus force the stomach contents out. Sometimes coughi...
