Causes of Hyperkalemia - Differential Diagnosis Framework • Cellular Shift: - Exercise - Metabolic Acidosis - Insulin deficiency, hyperglycemia, hyperosmolality - Medications: beta blockers, digitalis, cyclosporine, tacrolimus - Hyperkalemic periodic paralysis • Decreased Urinary Excretion: - Hypoaldosteronism: type 4 RTA, angiotensin inhibitors, meds (heparin, NSAIDS, cyclosporine, tacrolimus) - Decrease Response to Aldosterone: K sparring diuretics, distal RTA - Decreased distal tubule sodium and water delivery: volume depletion, - AKI/CKD • Increased production: TLS, Crush injury, Hemolysis • Pseudo hyperkalemia: Blood draw error (Collection technique/sample storage), Thrombocytosis, Leukocytosis UCSD Internal Medicine @ucsdim #Hyperkalemia #Differential #Diagnosis #Causes #potassium #high
