What should be the focus of the medical history in a child with acute hyperkalemia (high serum potassium levels)?

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

In a previously well child with acute hyperkalemia, the history should focus on the following:

  • How the blood sample was obtained
  • Potassium intake or recent blood product transfusion
  • Risk factors for transcellular shift of potassium (acidosis) or tissue death or necrosis
  • Use of medication associated with hyperkalemia (by the child, other family members, pets, or household visitors)
  • Presence or signs of renal insufficiency

Specific questions may be focused on the following:

  • Urine output (last void or number of wet diapers) and fluid intake
  • Cola-colored urine (which may indicate acute glomerulonephritis)
  • Bloody stool (which may indicate hemolytic-uremic syndrome [HUS])
  • Drugs present in the household (or used by recent visitors), such as potassium preparations, digoxin, and diuretics
  • Any history of trauma (crush injuries) or thermal injury (burns)

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