Magnesium is one of the body's electrolytes, Hypokalemia is rarely caused by consuming too little potassium because many foods such as beans, dark leafy greens, potatoes, fish, and bananas contain potassium. Abnormal heart rhythms Overview of Abnormal Heart Rhythms Abnormal heart rhythms arrhythmias are sequences of heartbeats that are irregular, too fast, too slow, or conducted via an abnormal electrical pathway through the heart. Heart disorders are They may develop even when the decrease is slight if people already have a heart disorder or take the heart drug digoxin.
If hypokalemia lasts for an extended time, kidney problems may develop, causing the person to urinate frequently and drink large amounts of water. The diagnosis is made by measuring a low potassium level in the blood. Doctors then try to identify what is causing the potassium level to decrease. If the cause is not clear, doctors measure how much potassium is excreted in urine to determine whether excess excretion is the cause.
This record, the electrocardiogram also known as an ECG Usually, potassium can be replaced by taking potassium supplements by mouth. Because potassium can irritate the digestive tract, supplements should be taken in small doses with food several times a day rather than in a single large dose. Special types of potassium supplements, such as wax-impregnated or microencapsulated potassium chloride , are much less likely to irritate the digestive tract.
To treat hypokalemia more rapidly, potassium is given by vein intravenously in the following situations:. Regarding i. It is critical also to correct the levels of serum magnesium, in order to achieve an adequate treatment of hypokalemia An extensive description of the treatment of hypokalemia can be found in Table 3. In most patients presenting with hypokalemia, the cause is apparent from the history e. Two are the major components for the diagnostic evaluation: a assessment of urinary potassium excretion in order to distinguish renal potassium losses e.
The renal potassium excretion is better assessed by a h urine collection. However, the potassium concentration or, preferably, potassium-to-creatinine ratio on a spot urine are alternatives.
Management of the underlying disease or contributing factors constitutes the cornerstone of therapeutic approach. Potassium should be gradually replaced, preferably by oral administration if clinically feasible.
In some patients, such as in endocrine related hypokalemia cases, multidisciplinary diagnostic and therapeutic approach is needed. The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of this review. This work did not receive any specific grant from any funding agency in the public, commercial, or not-for-profit sector.
National Center for Biotechnology Information , U. Journal List Endocr Connect v. Endocr Connect. Published online Mar Author information Article notes Copyright and License information Disclaimer. Correspondence should be addressed to A Vryonidou: moc. Received Mar 10; Accepted Mar This article has been cited by other articles in PMC. Abstract Hypokalemia is a common electrolyte disturbance, especially in hospitalized patients.
Keywords: hypokalemia, potassium, electrolytes, acid—base status, adrenal, kidneys. Introduction Hypokalemia is present when serum levels of potassium are lower than normal. Open in a separate window. Figure 1. Definition and prevalence of hypokalemia Hypokalemia is an electrolyte characterized by low serum potassium concentrations normal range: 3. Causes of hypokalemia Hypokalemia can be caused either by decreased intake of potassium or by excessive losses of potassium in the urine or through the GI tract 17 , Table 1 Causes of hypokalemia.
Table 2 Symptoms and signs of hypokalemia. Laboratory investigation of hypokalemia General diagnostic approach The underlying cause of hypokalemia is usually apparent after obtaining a detailed medical history and physical examination Assessment of urinary potassium excretion Potassium excretion in a h urine collection is the best way to assess the urinary potassium excretion Assessment of acid—base status Once urinary potassium excretion is measured, the following diagnostic possibilities should be considered in the patient with hypokalemia of uncertain origin.
Figure 2. Algorithm of the diagnostic approach to a patient with hypokalemia. Endocrine causes of hypokalemia Screening for primary aldosteronism PA is recommended for any case with spontaneous or diuretic induced hypokalemia and hypertension. Apparent mineralocorticoid excess Apparent mineralocorticoid excess AME is an autosomal recessive disease caused by deficiency of the enzyme 11beta-hydroxysteroid dehydrogenase type 2 11beta-HSD2 Glucocorticoid resistance syndrome Familial glucocorticoid GC resistance is a rare syndrome that is characterized by diminished cortisol action, which is mediated by the GC receptor GR Treatment of hypokalemia The treatment of hypokalemia has four aims: a reduction of potassium losses, b replenishment of potassium stores, c evaluation for potential toxicities and d determination of the cause, in order to prevent future episodes, if possible.
Table 3 Treatment of hypokalemia. Hypokalemia Treatment Comments Mild 3. Conclusion In most patients presenting with hypokalemia, the cause is apparent from the history e. Declaration of interest The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of this review. Funding This work did not receive any specific grant from any funding agency in the public, commercial, or not-for-profit sector.
References 1. Evidence-based management of potassium disorders in the emergency department digest. Emergency Medicine Practice FP Essentials Weir MR, Rolfe M. Potassium homeostasis and renin-angiotensin-aldosterone system inhibitors. Clinical Journal of the American Society of Nephrology Potassium homeostasis: the knowns, the unknowns, and the health benefits.
Physiology Potassium, magnesium, and calcium: their role in both the cause and treatment of hypertension. Journal of Clinical Hypertension Disorders of acid-base balance: new perspectives.
Kidney Disease Effects of a high sodium-low potassium diet on renal calcium, magnesium, and phosphate handling. American Journal of Physiology: Renal Physiology [epub]. Renal potassium physiology: integration of the renal response to dietary potassium depletion.
Kidney International DuBose TD. Regulation of potassium homeostasis in CKD. Advances in Chronic Kidney Disease New guidelines for potassium replacement in clinical practice.
Archives of Internal Medicine Wang WH, Giebisch G. Regulation of potassium K handling in the renal collecting duct. Renin-angiotensin-aldosterone RAAS : the ubiquitous system for homeostasis and pathologies. Biomedicine and Pharmacotherapy Physiology—Renal Physiology Dhondup T, Qian Q. Acid-base and electrolyte disorders in patients with and without chronic kidney disease: an update.
Potassium homeostasis, oxidative stress, and human disease. International Journal of Clinical and Experimental Physiology Potassium disorders- clinical spectrum and emergency treatment.
Resuscitation Other electrolyte imbalances e. Particularly acute extracellular changes in concentration influence excitability! Chronic changes lead to intracellular compensation! Hypomagnesemia can lead to refractory hypokalemia! Patients may be asymptomatic, particularly if the deficiency is mild. Hypokalemia and hyperkalemia can cause cardiac arrhythmia and may lead to ventricular fibrillation! All patients require an ECG and laboratory studies to confirm the diagnosis and rule out concurrent electrolyte abnormalities.
Further diagnostic tests depend on the suspected underlying etiology. Consider confirming abnormal serum potassium levels with a repeat blood draw. To remember that low pot assium may result in a flattened T wave, think of: "No pot , no tea T! IV potassium may cause local irritation and lead to cardiac arrhythmias. Therefore, it should always be administered slowly max.
Expand all sections Register Log in. Trusted medical expertise in seconds. Find answers fast with the high-powered search feature and clinical tools. Try free for 5 days Evidence-based content, created and peer-reviewed by physicians. Sign up for free, and stay up-to-date on research advancements, health tips and current health topics, like COVID, plus expert advice on managing your health.
Error Email field is required. Error Include a valid email address. To provide you with the most relevant and helpful information and to understand which information is beneficial, we may combine your e-mail and website usage information with other information we have about you.
If we combine this information with your PHI, we will treat all of that information as PHI, and will only use or disclose that information as set forth in our notice of privacy practices.
You may opt-out of e-mail communications at any time by clicking on the Unsubscribe link in the e-mail. Our Housecall e-newsletter will keep you up-to-date on the latest health information. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below.
A single copy of these materials may be reprinted for noncommercial personal use only.
0コメント