High potassium (hyperkalemia): Causes, prevention and treatment

high potassium
If you have kidney disease, your kidneys cannot remove the extra potassium in your blood. Learn how to control, prevent and treat high potassium (hyperkalemia) levels.
Medically reviewed by
AKF's Medical Advisory Committee
Last updated
October 27, 2023

What is high potassium, or hyperkalemia?

Everyone needs potassium to survive. Potassium is a mineral and an electrolyte. It helps your muscles work, including the muscles that control your heartbeat and breathing. Potassium comes from the food you eat.

Your body uses the potassium it needs. Your kidneys remove the extra potassium from your blood. When you have kidney disease, your kidneys cannot remove extra potassium in the right way, and too much potassium can stay in your blood.

When you have too much potassium in your blood, it is called hyperkalemia, or high potassium. Having too much potassium in your blood can be dangerous. Hyperkalemia can even cause a heart attack or death! Unfortunately, many people do not feel symptoms of hyperkalemia until it is too late and their heart health worsens.

Manage your potassium levels with diet and treatment. Visit Kidney Kitchen® for kidney-friendly recipes, nutrient information, and guides to help you cook and shop.

What causes high potassium?

The most common cause of high potassium is kidney disease.

Other causes of high potassium include:

  • Dehydration
  • Some medicines
  • Uncontrolled diabetes
  • Injuries that cause severe bleeding
  • Some rare diseases

If you have kidney disease, you are at risk for high potassium because your kidneys cannot remove the extra potassium in your blood. Instead of leaving your body through your urine, the extra potassium in your blood travels through your kidneys and back into your bloodstream. In time, more and more potassium can build up in your blood.

What are the symptoms of high potassium?

Many people do not feel symptoms of high potassium. Having too much potassium in your blood can be dangerous. It can even cause a heart attack.

If you do feel symptoms, some of the most common are:

  • Feeling tired or weak
  • Feeling sick to the stomach (nausea)
  • Muscle pains or cramps
  • Trouble breathing, unusual heartbeat, chest pains

If you have trouble breathing or think there could be a problem with your heart, call 911 for emergency help.

What are the complications of high potassium?

Having too much potassium in your blood can be dangerous. Potassium affects the way your heart's muscles work. When you have too much potassium, your heart may beat irregularly, which in the worst cases can cause heart attack.

If you think you are having a heart attack, call 911 for emergency help.

Some of the most common signs of heart attack are:

  • Feelings of pressure, pain, or squeezing in your chest or arms
  • Stomach pain or nausea
  • Shortness of breath
  • Breaking into a cold sweat
  • Sudden feelings of dizziness

Keep your potassium in balance

Learn how to keep your potassium levels in balance.

What are the tests for high potassium?

The only way to know for sure if your potassium level is healthy is to have a blood test. The test measures how much potassium is in your blood.

The blood test is like many other blood tests that you may be familiar with. A small needle is placed into a vein on your arm and your blood is drawn out into a tube. The blood is sent to lab to be tested.

Potassium may be called something else in your test results. If you do not see "potassium," look for either:

  • Serum potassium
  • K

A potassium of higher than 5.2 millimoles per liter (mmol/L) is usually considered high but your doctor or lab might use slightly different numbers. Talk to your doctor about what your test results mean.

Because very high potassium (higher than 6.0 mmol/L) can be dangerous, your doctor or nurse may contact you first if your results are unusually high. In this case, they may ask you to go to an emergency room or hospital.

What are the treatments for high potassium?

There are two ways to treat high potassium, through diet and/or medicine.

Potassium binders

Medicines for high potassium are called potassium binders. A potassium binder works by sticking to the potassium in your body and preventing some of it from being taken into your bloodstream. This helps to keep potassium from building up in your blood. The medicine is a powder, which you can take by mixing it with water and drinking. Talk to your doctor about whether a potassium binder could be an option for you.

Manage your potassium levels with diet and treatment

Download this guide to learn the amount of potassium in many common foods and know which foods are considered low, medium and high sources of potassium.

WATCH: RAAS inhibitors, potassium binders and the diet connection

Chicken Picadillo

Find delicious kidney-friendly recipes

Learn what healthy eating means for people in every stage of kidney disease, including those on dialysis or living with a kidney transplant.

Educational content made possible by AstraZeneca and Vifor Pharma.