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Kidney Disease
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Potassium 6.1

My nephrologist just called and said my potassium is 6.1 anyone out there this high? Any suggestions? Supposed to go in on Tuesday to get retested.

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6.1 is high. Usually, you can tweak your meal plan to bring it back in line. Staying well hydrated and avoid doing anything too strenuous within a couple of days of labwork will also help. Either that or get used to drinking Kayexalate in the ER. However, you might begin asking all of your physicians to provide you with hard copies of all your lab results, past, and future. For your immediate plan, use labtestsonline.org to check out what results are low, in- range, or high.

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Mr kidney thank you for your reply I always read your posts you r always helpful

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Hi Ga,

Yes, this is high. High range is usually anything over 5.4. Has this been an issue or was this an all time new high for you? I am surprised your doctor did not put you in the hospital. Be careful and don't do anything stressful. Not trying to scare you, but if you get chest pain, call 911. healthline.com/health/high-...

Drink water and look at what you have been eating. Potassium is in everything, even things you would not think. Also look at your medication especially any diuretics. Do not use salt substitutes.

You may want to try getting on a potassium binder. I did for a while but I was only 5.1. Not enough time to work because truthfully, I hated the taste. But there are others out there.

kidney.org/content/six-step...

mayoclinic.org/symptoms/hyp...

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Thank you bassetmommer I appreciate your thoughtful input

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Gal, I was informed recently that my potassium was too high at 5.8. I stopped eating meals containing tomatoes

/tomato sauces and cut out bananas and at the latest blood test my potassium has dropped to 5.2.

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FYI, if you follow a renal meal plan tomatoes and bananas wouldn't be an option. It's a good idea to stay in the low to mid-range of lab results for protein, phosphorous, potassium, sodium, and calcium. If you also have hypertension, keep the sodium above but near the low end of the range. It's not easy but it is worth it.

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Thank you, Mr Kidney but my history is a little more complicated than ‘just’ sometime raised high potassium.

Firstly, my renal consultant does not recommend a renal diet for me at this stage (sole kidney for last 60+ years, CKD 3b, eGFR 37).

I do drink plenty of water, eat a diet of mainly organic fruit and veggies etc (organic in an effort to avoid too many pesticides).

I do have extremely high blood pressure which, after trying many different medications, has become largely untreatable due to my body not tolerating the drugs and throwing up nasty side effects. My consultant said I am the worst patient he has come across with such sensitivity to meds - apparently being within approx 0.1% of the population so affected. After persevering on one of the latest pills to be added to my meds for the last 3 months, the leg/foot/ankle swelling and inflammation gave rise to my first ever bout of gout for which I am at present taking a short course of steroids and, of course, taken off yet another offending medication for which even adding a diuretic made no difference. NSAIDS such as Ibuprofen are usually the first choice treatment for gout but, as you will know, NSAIDs are contraindicated in those with CKD. In fact, along with scan contrast and an at-the-time undiagnosed/untreated inflammatory condition, they are implicated in my diagnosis of CKD some 12 years ago.

One of the meds my body does manage to tolerate is Losartan Potassium (hence the sudden potassium problem!), the 50g dose having been doubled by a cardiologist when I landed up in hospital in the autumn with chest pain caused by a leaking heart valve. Diagnosed by accident some 15 years ago as slightly leaking but never monitored since. Now at moderate to severe levels, it will be monitored in the future!

My sodium levels are always low - in fact one BP medication reduced them to such low levels that I suddenly found I could hardly put one foot in front of the other, hence another medication falling by the wayside!

I am managing to tolerate the Losartan, a relatively high dose of Moxonodine and Bisoprolol thus far - shame my BP doesn’t play ball!

So sorry for the long post but thank you for trying to help this complicated person that is me!

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You do seem to have some unusual issues to confront. Have you ever considered getting a second opinion? There are just so many things you are doing that "normally" are contraindicated for a CKD patient. A different physician (age, certification, experience, and training), might take you in a different direction and help you resolve some issues. Best of luck.

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“There are just so many things you are doing that “normally” are contraindicated for a CKD patient”.

My Kidney, thank you but I would be most grateful if you could kindly elaborate on what you mean, ie what “things”?

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Based on what you posted: 1) not on a kidney-friendly meal plan, 2) have they investigated all aspects of your medication intolerance, 3) steroid use, even on a limited basis, 4) Allopurinol for gout in place of NSAID's

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Many thanks for the further explanation. However, here in the UK, it’s unusual for our Doctors in primary care to even refer patients in the CKD3 range to NHS consultants in secondary care. They are in many cases not concerned until such patients reach stage 4-5. It’s a similar position with regard to referring such patients to renal dietitians. I have asked but to no avail. Perhaps if I was younger.....! Otherwise it would mean paying privately and I went down that route once but it proved a waste of time and money.

As for steroids, they are often prescribed for treating certain kidney conditions whereas Allopurinol was at one time a little suspect. In fact I had to take the steroid, Prednisolone, for over 6 years about 12 years ago for an inflammatory condition which without steroid treatment would have meant being in a wheelchair and, even worse, at the risk of having permanent loss of vision. My consultant rheumatologist at the time always reassured me that my kidney function would not be adversely affected by the steroids. Anabolic steroids taken by such people as body builders on the other hand are a different kettle of fish. I am quite reassured that the steroids I am taking for the gout for just 5 days at the moment are kidney protective. It is just 10mgs a day - when I started them 12 years ago, it was at a daily starting dose of 40mgs to protect my vision - the only medication available at the time to do so.

I do appreciate your thoughts and apologise for being complicated. You are especially helpful to people with your advice on this forum - I’m probably beyond help!

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Never give up. We all have to deal with the healthcare systems in our respective countries. Hang in there

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Losartan Potassium is a great blood pressure drug but it can raise your potassium to dangerous levels. It raised my potassium to 6.7 which is a potential heart attack number and I was taken off that drug and put on a diuretic. I also noticed you mentioned you have resistant hypertension. Have you ever been checked for sleep apnea? That can make hypertension resistant. There is also a procedure called "renal denervation" which can be used on people with hard-to-treat high blood pressure.

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Thank you so much I will check into that

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Steve, what dose of Losartan resulted in your scary episode with potassium?

I was on just 50mg for several years and have only had the issue with my potassium increasing to 5.8 just recently, probably as a direct result of a cardiologist doubling the Losartan dose 6 months ago when I ended up in hospital with a worsening leaky heart valve. However, my most recent potassium test was 5.2 which my renal consultant is happy with.

No, I haven’t been checked for sleep apnea but I don’t appear to have any of the listed symptoms, no snoring, coughing or feeling extra tired.

I have heard of renal denervation. I did once respond to a request for volunteers for a trial into something similar but got turned down with no reason mentioned - age possibly or BP perhaps being considered too high as I believe the reduction in BP aimed for in the trial was not unduly generous. Many thanks for your suggestions, Steve, which are much appreciated.

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I had spaghetti with tomatoe sauce now that’s out too

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Someone in this community suggested to me and I do like it, to substitute tomato sauce with pureed roasted red pepper. It's not the best but it is tolerable.

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I also cut out potatoes (french fries) etc. , oranges (orange juice), black beans, bran (granola), nuts (peanut butter), chocolate, AND "health" bars for energy ( they add potassium) also I stopped Ensure Plus.

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Thank you, Jim - all the foods I enjoy, and it’s quite disconcerting to find that so many healthy foods are on the ‘forbidden’ list. I usually have a small orange (satsuma) with my breakfast

each day, and I love nuts and apricots - they are both high in magnesium which I find helps me to avoid overnight leg cramps. However, I don’t eat the beans or the “health” energy bars or the bran. I’ll have to try and work on the rest, apart perhaps from the chocolate......!

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Well it's what you eat EVERY day, not once in a while. I do not know if the oranges you eat have preservatives sprayed on them, I know they spray them with food color. I never know if our fruit comes from other countries or not and other countries do not care about preservatives in the soil. We have to watch phosphates as well.

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Jim, we buy organic oranges in the hope that any spraying is kept to a minimum. In fact we eat mainly organic produce for the same reason - less toxins for the kidney to have to filter out.

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Hi GAL14, I too am surprised that your doctor did not send you to the ER or prescribe medications to correct your high potassium level. Why wait until Tuesday? Are you on dialysis? If so make sure to attend your dialysis, that will help correct it. Please continue to monitor your diet closely and avoid foods that contain potassium. Go to the ER if you experience any chest pain, shortness of breath or palpitations.

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He put me back on a potassium binder I am not on dialysis my gfr is 17 and getting back on list for kidney transplant

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Hi,

Had my bloods this week, take them myself, spin and take to my hospital, my potassium is normally 4.7 and settled now I am on nocturnal dialysis.

Took my bloods in the morning, got a call early afternoon to say my potassium was 7.5 and was asked to come straight into hospital, 7.5 is dangerously high. Fortunately after a check my first reading was in error, second test was 4.6 and all ok. My renal team were on the ball, thank yiy al.

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Yes, high potassium can cause your heart to stop! Cut out any foods with more than minimal potassium right away.

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Thanks for this I’m on it

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So what happens when your Potassium is too high or too low? You can die. You see we have thousands of nerve impulses going on every minute in the body, and the heart requires impulses to keep beating. Along the long nerve fiber Potassium ions (K) line up outside of the nerve and sodium ions (Na) on the inside. When an impulse comes down the nerve there is an ion exchange where they switch places. Now the sodium is outside and the potassium is inside. After a short time the nerve recovers for additional impulses. See this short explanation:

Here is the problem. If your potassium is way too high, when it is time for recovery, there is so much Potassium outside the nerve cell, the Potassium does not go back out. The nerve does not recover and the next impulse stops. For example the heart no long pumps blood. If the Potassium is way too low, there is not enough Potassium outside the nerve in places along the nerve and the impulse stops, so does the heart. So we all have to watch our levels of Potassium, because healthy kidneys help regulate Potassium levels. My kidneys are not healthy.

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Sobering thanks

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I was rushed to ER for 7.2, seems quite high, watch your potassium intake.

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Thanks Frankie, will do!

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I was 7.8 when I went to the er. They gave me a 5 part treatment to bring it down. Nebulizer,glucose, i.v. meds and pills. It came down I went home and was back in 2 hours. 7.2 this time! I suggested to my doctor my GI thought i should be tested for Addisons disease. And that was my answer. So if he's not gonna treat it today... stay away from potassium obviously (read all your labels), also stay away from salt substitutes. Are you craving salt? I have to take, with my other steroids, fludrocort. It helps keep potassium low and raises sodium.

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ok thank you!

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I have suffered from leg cramps for years. When the CKD was diagnosed I was at the worst cramping of my life. My dr told me to take a Tablespoon of apple cider vinegar at night. It has stopped the leg cramping for me. You might give it a try. Hope it helps.

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You should immediately go on a low potassium diet (if not already). 6.5 or higher needs to be treated urgently as a person can have sudden cardiac arrest at that number without any warning symptoms. In January my potassium was 6.7 which was discovered because I was in the ER due to a bad fall I had. There was a drug the doctors gave me to bring it down quickly and they took me off an ARB (blood pressure drug) and put me on a diuretic which can remove excess potassium from the kidneys. I haven't had any problems with potassium since then. ACE Inhibitors and potassium-sparing diuretics can also raise potassium levels, even in people with healthy kidneys, so it is something which needs to be monitored if you're on one of those medications.

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Thank you so much for this

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I Gal mine was high also, the dietician told me, no bananas, potatoes, tomatoes,etc..she gave me a list of what is to high and low potassium...it did go down but I have to limit what I eat..and yes pratically everything has potassium, drink lots of water.....and my nephrologist also gave me a water pill helps with the potassium and high blood pressure.....

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Could u give me the name of the water pill you take I will try for that with my doc

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