Hyperkalemia: Understanding Its Impact on Your Health

Mandy Trolinger, RD, PA-C

I was diagnosed with kidney disease as a child. I was on dialysis for one year and have had two kidney transplants—one from my mom and one from a deceased donor. I feel very lucky to have the gift of a kidney.

Growing up with kidney disease, I learned early on to understand my labs and became fascinated about the kidneys. You always miss what you don’t have, and I was so intrigued by how food impacts your health, I decided to go to school to be a registered dietitian (RD) and specialize in renal nutrition. I found that having been on dialysis and receiving a transplant gives me street cred with my patients. About 15 years ago, I went on to become a physician assistant (PA).

A “healthy diet” for the general population contains lots of fruits and vegetables, unfortunately it does not always work with people who have chronic kidney disease (CKD) or are on a dialysis diet. We need potassium in our diet but having too much or too little can cause serious consequences to our health.

Potassium is crucial for muscle and nerve function. Healthy kidneys typically eliminate any excess potassium, allowing it to exit the body through urine. Too much potassium can lead to serious health complications. When your level is too high, it is called hyperkalemia.

People with CKD face a higher risk of hyperkalemia because their kidneys are less effective at filtering out excess potassium from the bloodstream, and while dialysis does remove some potassium from your blood, it can still build up in between treatments.

People who are on dialysis or have later stage CKD must carefully monitor their potassium intake. When your potassium levels are high, you may not always notice a change in how you feel. Symptoms that have been reported are irregular heartbeat, cardiac arrest, and muscle paralysis, so it is nothing to mess around with.

My patients and friends who have CKD have reported they have experienced the following when their potassium was high:

“I felt weak and dizzy all the time. It was like my body was constantly struggling to function properly.”

“I experienced irregular heartbeats and chest pain. It was scary not knowing if my heart was going to give out.”

“When my potassium levels were high, I felt constantly fatigued, heaviness and weak. It was as if my body was just not able to move, and I had no energy to do anything. I just wanted to lay flat.”

Managing your potassium can be a two-pronged approach that involves working with your doctor on a plan that considers both a healthy diet alongside personalized treatment options. I love bananas but they are high in potassium so when I was on dialysis, I had to be mindful and learn if (and how much) I could eat based on my labs. This can be confusing, and this is where the renal dietitian can really help you choose the foods that are best for you. If your potassium is high your doctor may prescribe a medication to put in normal range.

It’s important to talk to your doctor, PA (advanced practitioners) and renal dietitian about your potassium.

You can learn more about hyperkalemia at UnfilteredKidneyConvos.com. For more guidance on what foods are renal-friendly, RSN has this cool nutrition calculator on their website (not an app) that can tell you the levels of potassium in foods.

Be informed and stay well. I know I do! I have two energetic kids, a loving husband, lots of pets and a full-time job. An ounce of prevention is worth a pound of cure!

Unfiltered Kidney Conversations

Nutrition Information for the Kidney Diet

Watch a video of me sharing my story

 

Mandy Trolinger is a physician assistant and registered dietitian, as well as a former dialysis patient and two-time kidney transplant recipient. She currently works as a nephrology physician assistant at Rocky Mountain Kidney Care in Denver, Colorado. She volunteers for many organizations, but her proudest accomplishment is her family.

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