Differential Diagnosis of Hyperkalemia

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Pseudo hyperkalemia
  • An important differential diagnosis due to poor sample collection techniques such as clenching or milking of the extremity that leads to hemolysis and hyperkalemia.
  • Can also arise after hemolytic transfusion reaction.
Tumor lysis syndrome
  • Differentiated by the presence of hyperuricemia and hypocalcemia.
Chronic kidney disease
  • Associated symptoms such as reduced urine output and uremic symptoms.
  • Deranged creatinine clearance and GFR.
Digitalis toxicity
  • Drug screen indicates presence of digitalis in circulation in a patient with a history of heart disease.
Injuries (trauma, burns)
  • History of occurrence preceding the onset of hyperkalemia.
Malignant hyperthermia
  • History of anesthetic use with other symptoms such as temperature change and tachycardia.

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