Would I have excreted excess potassium or shown symptoms of hyperkalemia (elevated potassium levels) by now, considering it's 11:45 and I ingested potassium-rich substances earlier?

Potassium Excretion and Symptom Timeline After Ingestion

If you ingested excess potassium earlier today and it's now 11:45, you would have either already excreted the excess through your kidneys (if they're functioning normally) or developed symptoms of hyperkalemia by now—the absence of symptoms at this point suggests your kidneys successfully handled the load.

Understanding Potassium Excretion Kinetics

Normal renal handling occurs rapidly. The kidney is the primary organ responsible for potassium excretion, accounting for approximately 90% of potassium elimination 1. In individuals with normal kidney function, potassium adaptation mechanisms allow the kidneys to excrete excess oral potassium efficiently, preventing dangerous accumulation 2.

• Potassium is initially filtered at the glomerulus and the distal nephron secretes potassium in response to increased intake 1
• The gastrointestinal tract can increase potassium excretion (normally ~10% of total elimination) as an additional compensatory mechanism 1
• Severe hyperkalemia from oral potassium is extremely rare if kidney function is normal because of potassium adaptation 2

Symptom Timeline for Hyperkalemia

Symptoms would have manifested within hours if dangerous levels developed. The acuity of intake and excessive quantity can overwhelm the kidneys' ability for adaptation, leading to rapid symptom onset 2.

Cardiovascular manifestations appear first:

• Electrocardiographic abnormalities develop as potassium rises above 5.5 mEq/L, with characteristic changes including peaked T waves, widened QRS complexes, and potentially life-threatening arrhythmias 3, 4
• Fatal dysrhythmias can occur with severe hyperkalemia, potentially leading to cardiac arrest 5, 2

Neuromuscular symptoms follow:

• General muscular weakness and ascending paralysis may occur 2
• Severe hyperkalemia can rapidly lead to paralysis of muscles that control ventilation 1

Gastrointestinal symptoms include:

• Nausea, vomiting, and paralytic ileus 2
• Local mucosal necrosis that may lead to perforation in extreme cases 2

Critical Risk Factors That Would Delay Excretion

You would be at higher risk for retained potassium and delayed symptoms if you have:

• Renal impairment (eGFR <45 mL/min/1.73 m²), as renal potassium excretion typically is maintained until GFR decreases to less than 10-15 mL/min/1.73 m² 1
• Diabetes mellitus, which increases hyperkalemia risk 1, 6
• Concurrent use of potassium-sparing diuretics, ACE inhibitors, ARBs, or aldosterone antagonists, which impair renal potassium excretion 6, 2
• Use of NSAIDs or calcineurin inhibitors, which reduce renal potassium excretion 6

What This Means for Your Situation

The absence of symptoms by 11:45 is reassuring. If you had normal kidney function and no medications interfering with potassium excretion, your kidneys would have begun eliminating excess potassium within hours of ingestion 1, 2. The oral potassium dose has to be large enough to overcome the normal renal excretory mechanisms to cause severe hyperkalemia, which occurs most commonly in patients with renal impairment or those taking specific medications 2.

However, monitor for these warning signs over the next 24 hours:

• Muscle weakness or paralysis 2
• Palpitations or irregular heartbeat 3
• Nausea or vomiting 2
• Numbness or tingling 3

Seek immediate medical attention if you develop:

• Severe muscle weakness or difficulty breathing 1, 2
• Chest pain or palpitations 3
• Any concerning symptoms, as hyperkalemia can be life-threatening 5, 2