What is not a cause of hyperkalemia: A. Impaired renal (kidney) function, B. Hyperaldosteronism, C. Acidemia (acidic blood condition)?

From the Guidelines

The correct answer to the question is B. Hyperaldosteronism, as it is not a cause of hyperkalemia, but rather leads to hypokalemia due to increased potassium excretion by the kidneys. Hyperaldosteronism, characterized by excessive production of aldosterone, promotes sodium retention and potassium excretion by the kidneys, resulting in lower blood potassium levels 1. According to the 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline, primary aldosteronism is defined as a group of disorders in which aldosterone production is inappropriately high, leading to increased potassium excretion, which may cause hypokalemia if prolonged and severe 1.

Key Points to Consider

• Hyperaldosteronism leads to hypokalemia, not hyperkalemia, due to increased potassium excretion by the kidneys.
• Renal failure and acidosis can cause hyperkalemia, but hyperaldosteronism does not.
• The 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline supports the definition of primary aldosteronism and its effects on potassium levels 1.

Clinical Implications

• In clinical practice, hyperaldosteronism should not be considered a cause of hyperkalemia, but rather a potential cause of hypokalemia.
• Patients with hyperaldosteronism may require monitoring of potassium levels and treatment to prevent hypokalemia, rather than hyperkalemia 1.

From the Research

Causes of Hyperkalemia

The following are potential causes of hyperkalemia:

• Impaired renal (kidney) function 2
• Acidemia (acidic blood condition) 2

Not a Cause of Hyperkalemia

Based on the provided evidence, the following is not a cause of hyperkalemia:

• Hyperaldosteronism: Hyperaldosteronism is actually associated with hypokalemia, not hyperkalemia 3, 4, 5, 6. Hyperaldosteronism leads to an increase in aldosterone levels, which promotes the excretion of potassium in the urine, resulting in hypokalemia.