- With Mayo Clinic hematologist
Ruben Mesa, M.D.
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Ruben Mesa, M.D.
Ruben A. Mesa, M.D.
Ruben A. Mesa, M.D., is board certified in internal medicine, hematology and medical oncology and is a consultant and section head in the Division of Hematology and Internal Medicine at Mayo Clinic, Rochester, Minn., and an associate professor of medicine at Mayo Medical School.
The Chicago-area native's primary field of interest is hematology with special interests in both acute and chronic leukemias — specifically the chronic myeloproliferative disorders (MPDs).
"I believe patients' understanding of their disease is a critical first step in the healing process," he says. "I believe that the Internet, carefully used, is a phenomenal resource for patients to be able to access high-quality and valuable information to understand both their diseases and various treatments."
Dr. Mesa has been with Mayo Clinic throughout his training since 1991 and is a graduate of Mayo Medical School. He is a member of the American Society of Hematology, the American Society of Clinical Oncology and the American College of Physicians.
His scholarship has focused on advancing the understanding and therapy of the chronic myeloproliferative disorders. In these disorders, he has been active in evaluating novel therapeutics, implementing clinical trials, working with quality of life studies, and actively involved with national patient groups.
He is supported in these efforts by research funding from the National Cancer Institute, the MPD Foundation, and Mayo Clinic's Hematologic Malignancy Program. He is principal investigator in several trials specifically for myelofibrosis, and is organizing a trial using exercise to counteract MPD-associated fatigue. He is committed to improving the therapy and quality of life in MPD patients. He has lectured both nationally and internationally on these disorders.
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Question
Hyperkalemia: What causes high potassium?
My doctor says I have high potassium. What causes this?
Answer
from Ruben Mesa, M.D.
The most common cause of high potassium (hyperkalemia) is impaired kidney function, such as due to acute or chronic kidney failure. Other causes of hyperkalemia include:
- Certain medications, such as angiotensin-converting enzyme (ACE) inhibitors
- Hormone deficiencies, including adrenal failure (Addison's disease)
- Destruction of red blood cells due to severe injury or burns
- Excessive use of potassium supplements
- Alcoholism or heavy drug use that causes rhabdomyolysis, a breakdown of muscle fibers that results in the release of potassium into the bloodstream
Most of the potassium in your body is within your cells. As a result, the amount of potassium in your red blood cells is much greater than in the liquid part of your blood (plasma or serum). Your kidneys control the excretion of potassium in your urine.
True hyperkalemia is a serious and potentially life-threatening disorder. It can cause:
- Muscle fatigue
- Weakness
- Paralysis
- Abnormal heart rhythms (arrhythmias)
- Nausea
Sometimes a report of high blood potassium isn't true hyperkalemia. Instead it may be caused by the rupture of red blood cells in the blood sample during or shortly after drawing the sample. The ruptured cells leak their potassium into the serum. This falsely elevates the amount of potassium in the blood sample, even though the potassium level in your body is actually normal. When this is suspected, a repeat blood sample is obtained.
