Factors Contributing to Hyperkalemia

Category

Examples

Decreased potassium excretion

Medications

Angiotensin-converting enzyme inhibitors

Angiotensin II receptor blockers

Potassium-sparing diuretics

Nonsteroidal anti-inflammatory drugs

Hypoaldosteronism

Adrenal insufficiency

Kidney disorders

Acute kidney injury

Chronic kidney disease

Renal tubular acidosis type 4

Urinary obstruction

Other

Decreased effective circulating volume

Increased potassium intake (usually iatrogenic)

Oral

Dietary

Oral potassium supplements

IV

Blood transfusions

IV fluids with supplemental potassium

Total parenteral nutrition

Increased potassium movement out of cells

Medications

Beta-blockers

Increased tissue catabolism

Acute tumor lysis

Acute intravascular hemolysis

Bleeding into soft tissues or gastrointestinal tract

Burns

Rhabdomyolysis

Inherited disorders

Hyperkalemic familial periodic paralysis (rare)

Insulin deficiency

Diabetes mellitus

Fasting

Other

Exercise

Metabolic acidosis