Heparin — And Hyperkalemia ((exclusive))

Acute kidney injury, adrenal insufficiency, pseudohyperkalemia (hemolysis, thrombocytosis), medications (list above).

The risk and severity of hyperkalemia vary depending on the formulation of heparin used. heparin and hyperkalemia

| Drug | Hyperkalemia Risk | |------|-------------------| | Unfractionated heparin (UFH) | Moderate–High | | Low molecular weight heparin (LMWH) | Low–Moderate (case reports) | | Fondaparinux | Very low (negligible) | | Direct oral anticoagulants (DOACs) | None | | Warfarin | None | Risk is highest with: Baseline potassium levels should

Not all patients develop hyperkalemia. Risk is highest with: Acute kidney injury

Baseline potassium levels should be obtained before initiating heparin therapy in patients with renal failure or diabetes. Serial monitoring of potassium levels is recommended every 2–3 days for high-risk patients.

First reported in the literature in the 1970s, heparin-induced hyperkalemia is often overlooked in clinical practice, potentially leading to cardiac arrhythmias and increased mortality, particularly in patients with underlying renal impairment. Understanding the mechanism of aldosterone suppression is critical for preventing this iatrogenic complication.

The condition is often asymptomatic until serum potassium levels reach critical thresholds. Symptoms may include: