Differential Diagnosis of Hyperkalemia
Single Most Likely Diagnosis
- Chronic Kidney Disease (CKD): This is often the most common cause of hyperkalemia due to the kidney's reduced ability to excrete potassium. CKD can lead to a gradual buildup of potassium in the blood.
Other Likely Diagnoses
- Medication Side Effects (e.g., ACE inhibitors, ARBs, beta-blockers, potassium-sparing diuretics): Many medications can increase potassium levels by reducing its excretion or increasing its release from cells.
- Cell Lysis (e.g., tumor lysis syndrome, rhabdomyolysis): Conditions that cause cell breakdown can release large amounts of potassium into the bloodstream.
- Adrenal Insufficiency: This condition, including Addison's disease, can lead to hyperkalemia due to the lack of aldosterone, which regulates potassium excretion.
- Dietary Excess: Consuming high amounts of potassium-rich foods or supplements can lead to elevated potassium levels, especially in individuals with impaired kidney function.
Do Not Miss Diagnoses
- Acute Kidney Injury (AKI): Sudden loss of kidney function can rapidly lead to dangerous levels of hyperkalemia, making it critical to identify and treat promptly.
- Hyperkalemic Periodic Paralysis: A rare genetic disorder that can cause life-threatening episodes of muscle weakness and hyperkalemia.
- Pseudohyperkalemia: A condition where laboratory results falsely indicate hyperkalemia, often due to hemolysis during blood sampling. Recognizing this can prevent unnecessary treatment.
Rare Diagnoses
- Hyporeninemic Hypoaldosteronism: A condition characterized by low renin and aldosterone levels, often seen in patients with diabetes or kidney disease, leading to hyperkalemia.
- Liddle's Syndrome: A rare genetic disorder affecting the kidneys' ability to regulate sodium and potassium, leading to hypertension and hyperkalemia.
- Gordon's Syndrome: A condition characterized by hypertension, hyperkalemia, and normal to low aldosterone levels, often due to genetic mutations affecting kidney function.
- Type IV Renal Tubular Acidosis: A condition where the kidneys fail to acidify the urine properly, leading to hyperkalemia among other electrolyte imbalances.