Hyperkalemia laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2] ; Aditya Ganti M.B.B.S. [3]

Overview

In a patient who does not have a risk for hyperkalemia, repeating the blood test is indicated before taking any actions unless changes are present on electrocardiography.

Laboratory Findings

Hyperkalemia is defined as serum potassium greater than 5.0-5.5 mEq/L in adults. Levels higher than 7 mEq/L can lead to significant hemodynamic and neurologic consequences, whereas levels exceeding 8.5 mEq/L can cause respiratory paralysis or cardiac arrest and can quickly be fatal. In a patient who does not have a risk for hyperkalemia, repeating the blood test is indicated before taking any actions unless changes are present on electrocardiography.

Grade Potassium level
Mild 5-7mEq/L
Moderate 7-8.5mEq/L
Severe >8.5mEq/L

Initial tests

  • Complete blood count (CBC)
  • Metabolic profile
  • Urine potassium, sodium, and osmolality

Cause specific

  • Blood glucose In patients with history of diabetes mellitus
  • Digoxin level
  • Arterial or venous blood gas (acidosis)
  • Urinalysis (renal insufficiency)
  • Serum cortisol and aldosterone levels (mineralocorticoid deficiency)
  • Serum uric acid and phosphorus assays (tumor lysis syndrome)
  • Serum creatinine phosphokinase (CPK) and calcium measurements and urine myoglobin test (crush injury or rhabdomyolysis)

References

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