Hyperkalemia causes

There are 2 broad categories for hyperkalemia:

Renal cause: most commonly due to renal failure.

Non-renal cause: ABCDE

Acidosis – from transcellular shift of potassium in exchange of extracellular H+

Beta antagonists

  • Beta-2 receptors causes uptake of potassium intracellularly via Na-K ATPase which is activated through a chain of events through formation of cAMP.
  • Inhibition of beta-2 receptors decreases the ATPase function and therefore reduces potassium intake.

Cellular destruction eg rhabdomyolysis, tumour lysis syndrome

Drugs which block RAAS (ACEi, spironolactone)

Endocrine eg hypoaldosteronism, pseudo-hypoaldosteronism (type I, type II – Gordon’s syndrome)

  • Type I: mutation in ENaC channel causes its loss of function.
  • Type II: mutation in Na-Cl channel causes its gain of function (opposite to Gitelman’s syndrome).

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