What tests should be performed first in the evaluation of suspected hyperkalemia (high serum potassium level)?

Updated: Apr 09, 2020
  • Author: Eleanor Lederer, MD, FASN; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Ascertain whether the elevated potassium level is real or factitious (see DDx). In a patient who does not have a predisposition to hyperkalemia, repeat the blood test before taking any actions to bring down the potassium level, unless changes are present on electrocardiography (ECG).

Renal function testing is important. If the patient has renal failure, the serum calcium level should be checked because hypocalcemia can exacerbate cardiac rhythm disturbances. Other tests include the following:

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