High Potassium and Your Kidneys

By Sue Hellie, MD, MBA

Potassium is an essential nutrient that plays a crucial role in several important bodily functions including muscle movements in the digestive tract, skeletal muscles that enable mobility, and cardiovascular muscles that keep the heart beating and supplying blood throughout the body. Healthy kidneys work to filter out extra potassium and remove it from the body through urine. When kidneys do not function properly, they may not be able to remove enough potassium.

Hyperkalemia (HK), also known as high potassium, is a condition that occurs when the potassium level in the blood is too high (over 5.0 mmol/L), which can cause serious complications if not treated.

Hyperkalemia and its Symptoms

In 2014, an estimated 3.7 million adults in the US were diagnosed
with HK, which can be associated with health conditions including chronic kidney disease (CKD). In fact, 40-50% of people living with CKD in the US are affected by HK.

Even though many times there are no symptoms of HK, too much potassium in the blood can cause irregular heartbeats, muscle weakness, numbness, tingling, or even death. In sudden or severe cases of HK, you may have shortness of breath, heart irregularities, chest pain, nausea, or vomiting. 

Understanding Potassium Levels

The only way to know if you have HK is through a blood test. Normal potassium levels are between 3.5 and 5.0 mmol/L. Any level above 5.0 mmol/L may be considered high and potentially dangerous. It’s important to remember your results only show the amount of potassium that was in your blood at the time you had the test. This is because your potassium level depends on:

• How well your kidneys are working

• How much of it you are getting in what you eat and drink each day

• If you are taking certain medicines that can affect your potassium level

• If you are taking certain medicines that lower potassium as prescribed by your doctor, such as potassium binders

For those who are on dialysis, which can help to lower potassium levels during treatment, it’s important to consult with a doctor to check potassium levels on a regular basis, as levels can increase between sessions.

Managing Hyperkalemia

Having access to resources is crucial to managing health complications and living a fuller, healthier life. As such, here are some ways you can take control of high potassium:

Assess your medications: If you are currently on medication to manage CKD, diabetes, or high blood pressure, ask your doctor about how these medications could be impacting your potassium levels. Your doctor may recommend options, such as taking medicine called a potassium binder and/or changing medicines that might contribute to hyperkalemia.

Implement a healthy diet: Make modifications to your eating habits that are consistent with your dietary requirements. It’s important to speak to your doctor or a dietician to make sure your diet is personalized for you. 

Adhere to your dialysis prescription: It’s important not to miss a dialysis treatment as that is the only way for people who do not have kidney function to rid their bodies of toxins, extra potassium being one of them.

Engage with the CKD Community: It’s important to know you are not alone. Consider engaging with others walking in your shoes to help educate yourself on kidney health and receive integral support on your wellness journey.

Talk to your doctor about HK and treatment options that may be right for you. It can be hard to talk about living with chronic disease, but open communication with your doctor can help you take control of your potassium levels and not just live—but thrive.


Sue Hellie, MD, MBA is the Head of US Medical Affairs, Renal at AstraZeneca. She has worked in the pharmaceutical industry for over 20 years. She joined AZ in 2021 and is responsible for the development of medical strategy and tactical execution for Chronic Kidney Disease and Hyperkalemia. Sue is a senior business executive with broad commercial, medical affairs and pipeline development expertise. Her experience spans drug development, franchise strategy development, product pre-launch and launch, brand management, medical strategy, post marketing/RWE studies in multiple disease areas such as CNS, Oncology, Hepatology, Women’s Health, Virology, Nephrology, Rare Disease and Diabetes.

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