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High Levels of Potassium in Urine

By Linda Tarr Kent

Potassium is an electrolyte that your body needs for good health. The balance of potassium in your body is regulated via excretion in your urine. It’s important to maintain the correct electrolyte balance in your body because electrolytes help your body's muscle action, blood chemistry and other important processes, according to the National Institutes of Health. Potassium is critical for proper function of your nerve and muscle cells, including the muscle cells in your heart, according to the Mayo Clinic.


Doctors determine the amount of potassium in your urine with a 24-hour urine sample. You collect your urine in a special container for a full day. If you are in the normal range you’ll have 25 to 120 milliequivalents of potassium per liter per day. Eating a large amount of potassium can cause high levels in your urine, but so can certain health conditions or medications, according to NIH.


Taking a diuretic may cause you to excrete more potassium in your urine, which can lead to a low level of potassium in your body, according to Merck. Vomiting also can cause you to excrete more potassium, according to NIH. If you excrete too much potassium, you can suffer confusion, fatigue, muscle weakness and cramps. Having too much potassium in your body is also dangerous, however. Your first symptom may be an abnormal heart rhythm. Having too much potassium is most often caused by kidney failure or drugs that cut the amount of this electrolyte that is excreted by your kidneys. Such drugs include angiotensin-converting enzyme (ACE) inhibitors and the diuretic spironolactone.


In addition to diuretics, certain other drugs, preservatives and herbs can cause you to excrete higher than normal levels of potassium in your urine. These include licorice, sulfates, penicillin, cortisone, thiazides, carbenicillin and ethylene diamine tetra-acetic acid anticoagulant, according to Frances Talaska Fischbach and Marshall Barnett Dunning, authors of “A Manual of Laboratory and Diagnostic Tests.”


If you suffer diabetic acidosis or other types of metabolic acidosis, you might end up with high levels of potassium in your urine, according to NIH. That’s because potassium stores are depleted during acidosis, then excreted in your urine, according to “Clinical Anesthesia,” by Paul G. Barash et al. You also are likely to end up with a high level of potassium in your urine if you have an eating disorder such as anorexia or bulimia, according to NIH. Increased urinary potassium occurs during the onset of starvation, Fischbach and Dunning say.

Expert Insight

High levels of potassium in the urine can be caused by Cushing syndrome or hyperaldosteronism, though these are both rare causes, according to NIH. Cushing syndrome is a disorder that can occur if you take steroid hormones or if your body is otherwise exposed to high levels of the hormone cortisol. It can cause upper body obesity, a moon face, a slow growth rate in children, acne, bone pain, excess facial hair in women and decreased fertility in men. Hyperaldosteronism occurs when your body’s adrenal gland releases too much of a hormone called aldosterone. Symptoms include fatigue, high blood pressure, headache, weak muscles, numbness and intermittent paralysis, according to NIH. The kidney disorder called acute tubular necrosis also can result in high levels of potassium in your urine. This disorder can lead to kidney failure.


If you excrete too much potassium, you are likely to be treated with potassium supplements or advised to eat foods high in potassium, according to Merck. If you are using a diuretic that causes potassium to be excreted in your urine, you may be given another type of diuretic that will reduce the amount excreted, referred to as a potassium-sparing diuretic.

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