A Case of Hyperkalemia Induced by Kratom (Mitragyna speciosa)

Kratom (Mitragyna speciosa), a tree found abundantly in Southeast Asia, has been used for centuries because of its opioid-like properties. In the last 20 years, it has gained popularity in the United States of America due to its easy availability and effects on pain control. However, different types of toxicity from kratom use have been reported in the literature. Here, we present a case of kratom-induced hyperkalemia in a 61-year-old patient with no significant past medical history. His laboratory work-up excluded other etiologies, and his potassium level eventually normalized after the discontinuation of kratom. Although reasonable data exist on kratom effects on the nervous and cardiovascular systems, the magnitude of its effect on potassium homeostasis and whether it is kidney mediated or not is not well recognized.