My 77-year-old grandmother is suffering from a high serum potassium level since she had gallbladder surgery. What causes this and what can keep it from getting too high?

Question

My 77-year-old grandmother is suffering from a high serum potassium level since she had gallbladder surgery. What causes this and what can keep it from getting too high?

Answer

The most common cause of high blood potassium, or hyperkalemia, is a hemolyzed sample of blood (where there is breakdown of red cells, due to faulty sampling) giving an erroneous reading. I'm sure that a repeat blood test has been given to your grandmother as it sounds as if this problem is remaining after her operation.

Since the kidneys normally excrete excess potassium rapidly, the occurrence of sustained high potassium levels usually implies diminished kidney function. Other causes of a high potassium could be consumption of large amounts of salt substitutes, and excessive tissue breakdown after, say, bleeding into soft tissues, or hemolysis (breakdown of red blood cells). Some diuretics (water pills), called potassium-sparing diuretics, can cause retention of potassium, as can beta-blocker drugs and excessive digitalis medication. High potassium is common in diabetic acidosis i.e. diabetes associated with increased acidity of the blood.

In order to treat high potassium levels, the cause must be found. Moreover, all hyperkalemic patients should have an EKG to see if cardiac effects are occurring. However, if the potassium continues to climb there are oral medications, such as sodium polystyrene sulfonate, that can be given to avoid any complications.