Podcast 1015: Calcium in Hyperkalemia

Contributor: Meghan Hurley, MD

Educational Pearls:

What is hyperkalemia?

Hyperkalemia is when the measured blood level of potassium reaches above 5.2 - 5.5 mEq/L (normal 3.5 - 5.2 mEq/L).

What are common causes of hyperkalemia?

Chronic or acute kidney disease.

Medications that impact the Renin-Angiotensin-Aldosterone-System (RAAS).

Hypoaldosteronism and primary adrenal insufficiency (Addison's Disease).

What are concerns of hyperkalemia?

The biggest concern with hyperkalemia is the impact on the cardiac conduction system.

At differing levels of hyperkalemia, the patient may initially have peaked T waves, that then progress into a widening of the QRS complex which may eventually lead to a sine wave pattern.

This increases risk for cardiac arrest with ventricular fibrillation, PEA, and asystole.