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Factors Contributing to Hyperkalemia

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Description	Cause	Examples
Decreased potassium excretion	Medications	Angiotensin-converting enzyme inhibitors Angiotensin II receptor blockers CyclosporineCyclosporine Direct renin inhibitor (aliskiren)Direct renin inhibitor (aliskiren) HeparinHeparin LithiumLithium Potassium-sparing diuretics Nonsteroidal anti-inflammatory drugs TacrolimusTacrolimus TrimethoprimTrimethoprim
	Hypoaldosteronism	Adrenal insufficiency
	Kidney disorders	Acute kidney injury Chronic kidney disease Renal tubular acidosis type 4 Urinary obstruction
	Other disorders	Decreased effective circulating volume
Increased potassium intake (usually iatrogenic)	Oral intake	Dietary Oral potassium supplements
	IV intake	Blood transfusions IV fluids with supplemental potassium Parenteral nutrition Potassium citrate solutionsPotassium citrate solutions Potassium-containing medications (eg, penicillin G)Potassium-containing medications (eg, penicillin G)
Increased potassium movement out of cells	Medications	Beta-blockers Digoxin toxicityDigoxin toxicity
	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 disorders	Exercise Metabolic acidosis