What Causes High Potassium Levels In Elderly?

The cause of high potassium levels in the elderly is chronic kidney disease, heart disease, diabetes, and diet.  Hyperkalemia or high potassium in the blood is an abnormally increased potassium level caused by heart and kidney problems.

What Causes High Potassium Levels In Elderly

Mayo Clinic has stated that potassium level is generally ranges between 3.6 to 5.2 millimoles per liter (mmol/L). If blood potassium level is higher than 6.0 mmol/L it can be dangerous and usually requires immediate treatment.

Mainly, it has to do with the abnormal potassium and sodium (salt) in the body, wherein it is filtered at the kidney. With that, whenever there is an abnormality that occurs within that area, blood pressure changes occur, and function is also affected.

Therefore, it is important to know what can be the specific cause of the matter. 

Chronic Kidney Disease (CKD)

Hyperkalemia or having high potassium levels in the kidney is often found in CKD suffering person and related with severe different results.

The increase of serum potassium is related to the decrease in the filtration of urine. And medications used to slow the progression of CKD and control associated diseases.

If there is high amount of  potassium in the body, fit kidneys will take out the excess amount of  potassium, and discard it from the body via urine.

Nevertheless, when kidneys do not work well, they may not be able to remove enough potassium. This means that potassium can build up in your blood to harmful levels. Symptoms of stomach ache and confusion can occur.

Other factors can be identified, whether that’s chronic or acute kidney disease. It may arise from acute volume exhaustion from dehydration or reduction in circulating blood due to heart failure. Tubular dysfunction caused by lessening of  aldosterone or insensitivity can also result in hyperkalemia. 

From the CDC, a kidney diet is recommended to control the level of potassium on your kidneys. Oranges, tomatoes, bread, and many other items are rich in potassium. Apples, and white bread have less amount of potassium. Your doctor may prescribe a potassium binder, a medicine that helps your body get rid of extra potassium.


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Heart Disease and Medications

If the kidneys are affected, there is a high chance that the heart is also included as part of the complication. As it is correlated to sudden cardiac death from unchecked high potassium levels, some patients with heart failure who are under medications are affected with hyperkalemia. Therefore, a strict dosage is required from the physician. 

According to Deepak L. Bhatt, MD, MPH from Harvard Health Publishing, diuretic medications reduce sodium and water in the body. He mentioned how “potassium-sparing diuretics, tend to raise potassium levels in the blood. Examples of these include spironolactone (Aldactone, generic) and triamterene (Dyrenium, generic).”

There is also a rise of people with high potassium levels and heart failure (HF), then the first two conditions above. 

ACE inhibitors can contribute to raising blood potassium levels. Other medications like Renin-angiotensin-aldosterone system (RAAS) antagonists, including angiotensin-converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARB), and mineralocorticoid receptor antagonists (MRA) were observed to decrease mortality in HF individuals.

Therefore, periodic testing, dietary approach, and awareness of drug interactions are necessary to check potassium levels and kidney function. If left unchecked patients can suffer from cardiac arrhythmias and sudden cardiac death. 


There are studies that mention about the low level of insulins can be associated with high potassium levels. Meaning, on the way around, low potassium levels are associated with high blood sugar. Still, this is a factor to be mindful of. Because administration of insulin shall be consistent in any way or it can lead to high blood sugar. 

According to WebMD, high blood sugar damages the kidneys, which normally remove extra potassium from your body. People with diabetes and high potassium are more likely to have heart problems and other complications. Poorly controlled diabetes will lead to unawareness of the elderly due to neuropathy and can lead to death from cardiac arrest.


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Diet and Others

A high potassium diet can lead to hyperkalemia, especially with patients who have advanced kidney disease or end-stage kidney disease. Cantaloupe, honeydew, orange juice, and banana are some foods that are high in such. Other people also take food supplements that are either salt substitutes or have extra potassium than the normal amount needed a day. 

Causes of High Potassium Levels In Elderly

There are other causes of high potassium, especially in the elderly. These are injury (damage to tissues can let the potassium levels to move and chance), Hypoaldosteronism or pseudohypoaldosteronism (less of the hormone aldosterone), and congenital adrenal hyperplasia (a rare disease from a gene mutation causing low aldosterone).


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Signs and Symptoms of High Potassium Levels In Elderly

Many patients don’t experience symptoms and signs until a cardiac episode has already occurred. Especially if they are diabetic, or have end-stage renal disease.

They may appear mild and non-specific. It usually develops slowly, over many weeks or months, and can recur. Here are the following signs and symptoms to be mindful of: 

Causes Hyperkalemia In Elderly

Muscles Weakness

Potassium is responsible for the function of your nerve and muscles. As the activity of the organs has been disrupted from the high levels of potassium, you can develop muscle fatigue and might not be able to walk. Most patients who experience hyperkalemia reports fatigue, inability to continue the activity, and a dull continuous ache in their muscles. 


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Numbness and Tingling

As blood potassium continues to rise, blood flow on your body also interrupts the function of the nerves. Therefore, as muscle fatigue and pain continues, numbness and tingling sensation can be felt not only in one part of the limbs but all over the body. The response of the elderly might come as “tingling sensation and crawling nerve pain all over the body.”

Nausea and Vomiting

One sign of having high potassium levels is nausea and vomiting. It can be associated with a stomach ache, gas, and bloating. Loose stool or diarrhea can also occur, which can lead to dehydration that can aggravate symptoms of kidney disease, especially if they are diagnosed with CKD. Call your doctor immediately if these are experienced. 

Shortness Of Breath

Shortness of breath can be associated with high potassium levels. As referenced at his can be caused by the muscles that control the breathing, the nerves that control it are also affected. With the inability to receive blood, and innervation, tightness on the chest can also develop.  If you feel like you are running out of breath and suffocating, seek medical attention immediately.

Irregular Heartbeat

Having an irregular heartbeat, or cardiac arrhythmia is one of the serious symptoms of having hyperkalemia. This means that high potassium in the body continues to be high and in need of immediate emergency action. An irregular heartbeat can be perceived as it is beating too slow, or too fast

It can also be associated with a tight pressure on your chest, pain that radiates to the (L) lateral side of your arm and shoulders, and unable to breathe. The description to differentiate it from heartburn or dizziness is the feeling of “having a large animal on my chest.” An immediate action to alleviate these will be highly needed. 


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Diagnosis Of High Potassium Levels In The Elderly

Most of the elderly don’t experience the symptoms at all. But this makes it difficult for doctors to figure whether it is true or not. Laboratory test of Complete Blood Count (CBC) to see if there are any irregularities on the blood serum and content has occurred.

Secondly is a Urinary Tract Function, to check whether each kidney is working and doesn’t have any damage or irregularities. 

Some doctors also request a urinalysis to check if levels of potassium and sodium are normal. In addition, an electrocardiogram will be needed to check if there are any irregularities in your heartbeat.

If it is chronic, these tests will be acquired periodically, and carrying out routine laboratory work will be important. Medications will also be checked, especially if you have a heart problem. 


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Treatment of High Potassium Levels in Elderly

Treatment options of high potassium can vary. If the patient has been to the hospital with severe symptoms, intravenous therapy will be administered. You will be infused with insulin, to help lower down and excrete the excess potassium in your body. Some physicians administer asthma medications to lower it down. 

Treatment of High Potassium Levels In Elderly

Medication management has also seen a potential for treating hyperkalemia. Especially if they are take ACE inhibitors and diuretics. Or for elderly people who have heart failure and symptoms involved. Blood pressure medications can be a tricky topic to venture into, but your healthcare provider can provide proper guidelines on the drug that’s right for you. Here are more details to help the elderly to take medications

As seen above on the causes of high potassium, doctors recommend drinking a potassium binder. Daily medication is taken and binds to excess potassium in the intestines. Therefore, excretion will be the method of removing the potassium in your body. Instead of the kidneys. This can be a last resort if all other treatments are not successful. 

All else, if there is no effective treatment for you, and had to experience kidney failure, dialysis will help filter the excess solutes and potassium in your body. Here are some other ways to prevent hyperkalemia

About Estephanie Jill

Estephanie Jill (EJBP, BSPT, PTRP) is a licensed physiotherapist. She is a home health care provider, laboratory technician for physical therapy students, medical transcriptionist, and an advocate of the physiotherapy profession. Apart from that, she loves writing. Playing to her strengths, she mainly writes around health and fitness, She has been commended for her writing in the past. Her other passions include commenting on societal changes and writing life reflective pieces. She enjoys meaningful conversations, and detaching from the digital world to do yoga and meditation. She is a self-confessed foodie who enjoys eating for the experience and then burning it all off through exercise.