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Pediatric Hypokalemia Differential Diagnoses

  • Author: Michael J Verive, MD, FAAP; Chief Editor: Timothy E Corden, MD  more...
 
Updated: Nov 11, 2015
 
 

Diagnostic Considerations

Important considerations

Adequately communicate the risks of treatment to the caregivers and/or patient.

Monitor patients receiving potassium supplementation for complications, especially patients with renal failure or patients receiving potassium-sparing diuretics or angiotensin-converting enzyme inhibitors.

Follow serum potassium and other electrolyte concentrations during or after therapy.

Ensure adequate precautions against treating a patient on the basis of a low serum potassium value that is false because of a sampling or laboratory error. However, do not fail to treat a patient with symptoms of actual hypokalemia because of an elevated serum potassium value that is false because of a sampling or laboratory error.

Other considerations

Pseudohypokalemia may be seen with sampling errors, particularly if a blood sample is taken upstream of an infusion of saline, dextrose, or other fluids that contain little or no potassium. Clues to sampling errors include other serum level abnormalities that reflect sampling of a mixture of blood and the fluid that is infused. Additionally, the new onset of hypokalemia in otherwise stable patients without known risk factors may reflect the use of different equipment/methods used for blood analysis, and this diagnosis should be confirmed using alternative methods prior to initiating treatment.

Differential Diagnoses

 
 
Contributor Information and Disclosures
Author

Michael J Verive, MD, FAAP Pediatrician, UP Health System Portage

Michael J Verive, MD, FAAP is a member of the following medical societies: American Academy of Pediatrics, Society for Pediatric Sedation

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Barry J Evans, MD Assistant Professor of Pediatrics, Temple University Medical School; Director of Pediatric Critical Care and Pulmonology, Associate Chair for Pediatric Education, Temple University Children's Medical Center

Barry J Evans, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Chest Physicians, American Thoracic Society, Society of Critical Care Medicine

Disclosure: Nothing to disclose.

Chief Editor

Timothy E Corden, MD Associate Professor of Pediatrics, Co-Director, Policy Core, Injury Research Center, Medical College of Wisconsin; Associate Director, PICU, Children's Hospital of Wisconsin

Timothy E Corden, MD is a member of the following medical societies: American Academy of Pediatrics, Phi Beta Kappa, Society of Critical Care Medicine, Wisconsin Medical Society

Disclosure: Nothing to disclose.

Additional Contributors

G Patricia Cantwell, MD, FCCM Professor of Clinical Pediatrics, Chief, Division of Pediatric Critical Care Medicine, University of Miami Leonard M Miller School of Medicine/ Holtz Children's Hospital, Jackson Memorial Medical Center; Medical Director, Palliative Care Team, Holtz Children's Hospital; Medical Manager, FEMA, South Florida Urban Search and Rescue, Task Force 2

G Patricia Cantwell, MD, FCCM is a member of the following medical societies: American Academy of Hospice and Palliative Medicine, American Academy of Pediatrics, American Heart Association, American Trauma Society, National Association of EMS Physicians, Society of Critical Care Medicine, Wilderness Medical Society

Disclosure: Nothing to disclose.

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