hepatic encephalopathy..??

[rj90]

so I had a pt with a whole list of issues, including hepatic encephalopathy. she had high bilirubin levels as well as continuously rising potassium, the latest was 6.3. I heard that high bili levels can cause increase in potassium. is this true?? the whole thing is confusing to me....

[Nurseboy1]

So remember that bilirubin is a function of RBC breakdown, by the liver and spleen, which is cleared from the body by the liver. When the liver fails it can no longer clear the bilirubin which causes it to rise. It really has nothing to do with potassium. I would imagine that the hyperkalemia may be coming from some kidney dysfunction which is common in end-stage liver failure. There may be medications involved since it is common for patients in liver failure to be on aldactone as well.