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Physiological and pathological changes are main inducing factors of diminished kidney function, which includes trauma, infection, inflammation, immune response, blood circulatory disorder, etc.
Impaired renal function (usually, estimated GFR from stable serum creatinine level <20 mL/min) can cause hyperkalemia. In the setting of preserved renal function (GFR >20 mL/min), serum aldosterone, renin, and cortisol levels can distinguish other causes .