Differential Diagnosis for 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
- Acute Kidney Injury (AKI): Similar to CKD, AKI can cause a sudden decrease in potassium excretion, leading to hyperkalemia.
- Medication Side Effects (e.g., ACE inhibitors, ARBs, beta-blockers, potassium-sparing diuretics): Certain 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.
Do Not Miss Diagnoses
- Adrenal Insufficiency: This condition, including Addison's disease, can lead to hyperkalemia due to the lack of aldosterone, a hormone that regulates potassium excretion.
- Type 4 Renal Tubular Acidosis: This condition is characterized by hyperkalemia and metabolic acidosis due to impaired renal acidification and potassium secretion.
Rare Diagnoses
- Hyporeninemic Hypoaldosteronism: A condition where there is a deficiency of renin and aldosterone, leading to impaired potassium excretion.
- Pseudohyperkalemia: A condition where elevated potassium levels are seen in the laboratory but not in the body, often due to hemolysis during blood sampling or extremely high white blood cell counts.
- Familial Hyperkalemic Periodic Paralysis: A rare genetic disorder that affects potassium channels, leading to episodes of hyperkalemia and muscle weakness.