TABLE. Common Causes of Hyperkalemia

Endogenous Causes
    • Chronic renal failure
    • Metabolic acidosis (eg, diabetic ketoacidosis)
    • Pseudohypoaldosteronism type II (also known as Gordon’s syndrome; familial hyperkalemia and hypertension)
    • Chemotherapy causing tumor lysis
    • Muscle breakdown (rhabdomyolysis)
    • Renal tubular acidosis
    • Hemolysis
    • Hypoaldosteronism (Addison’s disease, hyporeninemia)
    • Hyperkalemic periodic paralysis
Exogenous Causes
    • Medications: K+-sparing diuretics, ACE inhibitors, nonsteroidal anti-inflammatory drugs, potassium supplements, penicillin derivatives, succinylcholine, heparin therapy (especially in patients with other risk factors), β-blockers
    • Blood administration (particularly with large transfusions of older “bank” blood)
    • Diet (rarely the sole cause), salt substitutes
    • Pseudohyperkalemia (due to blood sampling or hemolysis, high white blood cell count, high platelets, tumor lysis syndrome)