Hyperkalemia is an excess of serum potassium. Most potassium in the body (98%) is found within cells; only a small amount usually circulates in the bloodstream. The balance of potassium between the cells and the blood is critical to the body. It affects the way the cell membranes work and governs the action of the heart and the pathways between the brain and the muscles. If you have excess potassium in the blood, it is usually excreted by the kidneys. However, the levels can get too high if your kidneys aren't working right, which is the most common cause of hyperkalemia. Another cause is damaged cells' releasing potassium into the bloodstream faster than even normal kidneys can clear it. Medications or diet may also affect the amount of potassium in the blood. Hyperkalemia is a serious condition that must be treated promptly.

• Fatigue
• Weakness
• Tingling, numbness, or other unusual sensations
• Paralysis
• Palpitations
• Difficulty breathing

Hyperkalemia has many causes, including the following.

• Kidney problems
• Too much acid in the blood, as sometimes seen in diabetes
• Diet high in potassium (bananas, oranges, tomatoes, high protein diets, salt substitutes, potassium supplements)
• Trauma, especially crush injuries or burns
• Addison's disease
• Certain medications

You may not be feeling any effects of your hyperkalemia; your health care provider may discover it during a routine blood test or electrocardiogram. Hyperkalemia can cause life-threatening effects without warning. If you experience the symptoms of hyperkalemia, you should call 911 or get to an emergency room. You should expect to be admitted to the hospital for further tests and so that your condition can be stabilized. You will be given medications to take care of the immediate problem, but more tests may need to be done to determine the underlying cause. If the medications are not successful in lowering the potassium level in your blood, dialysis may be recommended.

The medications that treat hyperkalemia are meant to stabilize cardiac function, promote the movement of potassium from the bloodstream back into the cells, and encourage the excretion of excess potassium.

• Insulin—promotes potassium shift from blood to cells
• Sodium bicarbonate—promotes potassium shift from blood to cells
• Beta agonists—promote potassium shift from blood to cells
• Diuretics—cause potassium excretion from kidneys
• Binding resins—promote potassium/sodium exchange in the gastrointestinal system

Alternative therapies can provide concurrent support and in treatment of the underlying cause once your condition has been stabilized.

• Avoid alcohol, caffeine, refined foods, sugar, and saturated fats (meat proteins and dairy products). Eliminate high-potassium foods.
• Drink more water; dehydration can make hyperkalemia worse.
• Eat small amounts of protein and more vegetable proteins and fish than chicken and red meats.
• Small, frequent meals can help prevent hypoglycemia.
• Magnesium (200 mg two to three times per day) helps regulate potassium levels.

Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots.

Of primary concern is the effect of hyperkalemia on the heart.

• Hawthorn (Crataegus monogyna) increases cardiac output without increasing cardiac load. It dilates blood vessels, helps stabilize cardiac arrhythmias, and also supports liver function. Compromised liver function and poor fat digestion can make hyperkalemia worse. Drink 3 to 4 cups of tea per day.
• Lily of the valley (Convalleria majalis) increases cardiac output and has a regulating effect on heart rhythm. It is a diuretic that relieves swelling and has a neutral to slightly lowering effect on sodium and potassium. This herb has toxic side effects and should not be used without supervision from your health care provider.

Homeopathy may be useful as a supportive therapy.

Contrast hydrotherapy. Alternating hot and cold applications brings nutrients to the site and eases inflammation. Use the applications over the kidneys. Alternate three minutes hot with one minute cold. Repeat three times to complete one set. Do two to three sets per day.

Acupuncture may be helpful in supporting normal kidney function.

Swedish massage may help to stimulate the kidneys.

Your health care provider will probably ask to see you two or three days after you are discharged from the hospital, to repeat the potassium tests and electrocardiogram, and check your kidney function. He or she will review all the medications you are taking, and perhaps advise a change.

If you are on regular dialysis, make sure you keep strictly to your schedule to avoid hyperkalemia and other serious problems.

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Lee HS, Yu YC, Kim ST, Kim KS. Effects of moxibustion on blood pressure and renal function in spontaneously hypertensive rats. Am J Chin Med. 1997;25: 21-26.

Wheeless CR. Management of Hyperkalemia. Wheeless' Textbook of Orthopaedics. 1996. Accessed at http://wheeless.belgianorthoweb.be/oo3/24.htm on February 17, 1999.

Zwanger M. Hyperkalemia. Emergency Medicine Online Text. 1998. Accessed at http://www.emedicine.com/emerg/topic261.htm on February 13, 1999.