Impaired excretion Medications:  Angiotensin-converting enzyme inhibitors  Angiotensin-II receptor blockers  Aldosterone antagonists and other potassium-sparing diuretics  Digoxin  Beta blockers  Heparin  Trimethoprim/sulfamethoxazole  Calcineurin inhibitors  Nonsteroidal anti-inflammatory drugs Reduced effective plasma volume Renal failure:  Acute renal failure  End-stage renal disease  Type 4 renal tubular acidosis

Transcellular shift Ongoing release:  Tumor lysis syndrome  Rhabdomyolysis  Severe hemolytic anemia  Extensive burn injury Other transcellular shifts:  Metabolic acidosis  Hyperglycemia Pseudohyperkalemia caused by hemolysis during venipuncture, small needle, sustained tourniquet, transport on pneumatic tube system, thrombocytosis (> 500,000 per mm3), or leukocytosis (> 70,000 per mm3) due to potassium released during clotting

Increased intake Blood transfusions Commercially available salt substitutes and potassium-enriched foods Enteral feeding High-potassium diet* Intravenous fluids Parenteral nutrition