What is the prevalence of hyperkalemia (high serum potassium level) among different age groups?

Updated: Jun 20, 2018
  • Author: Eleanor Lederer, MD, FASN; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

Several series document the increasing tendency for hyperkalemia in patients at the extremes of life—that is, small premature infants and elderly people. Renal insufficiency plays a significant role in both groups.

Studies in small premature infants indicate that the incidence of hyperkalemia is increased in infants with a lower GFR, as estimated on the basis of endogenous creatinine clearance. In these cases, hyperkalemia often occurs within the first 48 hours of life. Even full-term infants may have transient hyperkalemia and hyponatremia due to decreased responsiveness to aldosterone (PHAI). [22]

Several factors contribute to the increased propensity for elderly people to become hyperkalemic. Renal function tends to deteriorate with age, even in relatively healthy individuals. The GFR decreases by approximately 1 mL/min each year in people older than 30 years. Renal blood flow also decreases. Oral intake declines, resulting in decreased urine flow rates. Plasma renin activity and aldosterone levels also tend to decrease with age, reducing the ability of the distal nephron to secrete potassium.

Elderly patients are more likely to be taking medications that could interfere with potassium secretion, such as NSAIDs, ACE inhibitors, and potassium-sparing diuretics. Elderly individuals who are bedridden often are placed on subcutaneous heparin, which can decrease aldosterone production.


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