Hypokalemia Questions & Answers

Updated: Dec 06, 2018
  • Author: Eleanor Lederer, MD, FASN; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Questions & Answers

Overview

What is hypokalemia (low potassium)?

What causes hypokalemia (low potassium)?

What is Gitelman syndrome?

What are the signs and symptoms of hypokalemia (low potassium)?

Which physical findings suggest hypokalemia (low potassium)?

Which tests are initially performed in suspected hypokalemia (low potassium)?

What causes hypokalemia (low potassium)?

What does alkalosis suggest in patients with hypokalemia (low potassium)?

Which tests are performed to diagnose hypokalemia (low potassium)?

What are the 4 facets of treatment for hypokalemia (low potassium)?

How is potassium loss decreased in individuals with hypokalemia (low potassium)?

How is potassium loss replenished in individuals with hypokalemia (low potassium)?

When is surgical intervention indicated in the treatment of hypokalemia (low potassium)?

What is potassium?

How much potassium is absorbed in the GI tract, and how is it excreted?

How is potassium homeostasis maintained?

Which factors increase potassium excretion?

Which factors decrease potassium excretion?

How does potassium intake affect kidney function?

What is the role of the kidneys in the maintenance of potassium homeostasis?

How is potassium distributed across the cell membrane?

Which factors regulate the distribution of potassium between intracellular and extracellular space?

What are the physiological mechanisms for sensing extracellular potassium concentration?

What is the role of muscle in the regulation of serum potassium?

What is the pathophysiology of a low potassium state?

Which pathogenetic mechanisms cause hypokalemia (low potassium level)?

Which mechanisms may increase renal potassium losses?

What is the pathogenesis of hypokalemia (low potassium level) caused by vomiting?

What is the role of volume depletion in the pathogenesis of hypokalemia (low potassium level)?

What is the effect of hypokalemia (low potassium level) caused by a shift from extracellular to intracellular space?

What are the common signs and symptoms of hypokalemia (low potassium level)?

What are cardiovascular complications of hypokalemia (low potassium level)?

What are the risk factors for cardiac arrhythmias in patients with hypokalemia (low potassium level)?

Is low potassium intake a risk factor for the development of hypertension and/or hypertensive end-organ damage?

What are the possible muscular complications of hypokalemia (low potassium level)?

What are the possible renal complications of hypokalemia (low potassium level)?

What are GI complications of hypokalemia (low potassium level)?

What are the possible metabolic complications of hypokalemia (low potassium level)?

What is Bartter syndrome?

What is Gitelman syndrome?

What is the etiology of hypokalemia (low potassium level)?

What causes inadequate potassium intake?

What causes increased potassium excretion?

What are endogenous sources of excess mineralocorticoid in patients with hypokalemia (low potassium level)?

What are exogenous causes of mineralocorticoid excess in patients with hypokalemia (low potassium level)?

What are the GI causes of potassium loss?

Which drugs may cause hypokalemia (low potassium level)?

Which genetic disorders cause hypokalemia (low potassium level)?

Which genetic mutations cause Bartter syndrome?

Which genetic mutations cause Bartter syndrome 4B?

Which genetic mutations cause autosomal dominant hypocalcemia (ADH)?

What are the signs and symptoms of Bartter syndrome?

How is Gitelman syndrome differentiated from Bartter syndrome?

What is Liddle syndrome?

What is Gullner syndrome?

How is Gullner syndrome differentiated from Bartter syndrome?

What is glucocorticoid receptor deficiency syndrome?

What is hypokalemic periodic paralysis?

What is thyrotoxic periodic paralysis (TTPP)?

What is seizures, sensorineural deafness, ataxia, mental retardation, and electrolyte imbalance (SeSAME) syndrome?

What causes seizures, sensorineural deafness, ataxia, mental retardation, and electrolyte imbalance (SeSAME) syndrome?

What are the possible causes of a shift of potassium to the intracellular space?

What is the prevalence of hypokalemia (low potassium level)?

What is the role of non-potassium-sparing diuretics in the development of hypokalemia (low potassium level)?

What are the risk factors for hypokalemia (low potassium level)?

How does age affect the frequency of hypokalemia (low potassium level)?

What are the mortality rates of hypokalemia (low potassium level)?

What education should be provided to patients with hypokalemia (low potassium level)?

What is the prognosis of hypokalemia (low potassium level)?

Presentation

What are the signs and symptoms of hypokalemia (low potassium level)?

What causes poor potassium intake?

What causes increased potassium excretion?

What causes a shift of potassium to the intracellular space?

Which physical findings suggest hypokalemia (low potassium level)?

DDX

How are sampling errors identified in suspected hypokalemia (low potassium level)?

What are the differential diagnoses for Hypokalemia?

Workup

How is hypokalemia (low potassium level) defined?

How is hypokalemia (low potassium level) diagnosed?

What is the role of ECG in the diagnosis of hypokalemia (low potassium level)?

Which tests are performed in the evaluation of suspected hypokalemia (low potassium level)?

What is the role of urine potassium assay in the diagnosis of hypokalemia (low potassium level)?

Which etiological factors may cause a urine potassium level of less than 20 mEq/L?

What does a urine potassium level higher than 40 mEq/L indicate in a patient with hypokalemia (low potassium level)?

What is the role of 24-hour urine potassium excretion measurement in the diagnosis of hypokalemia (low potassium level)?

What is the role of urine sodium and osmolality test in the diagnosis of hypokalemia (low potassium level)?

What is the role of the urine sodium to chloride ratio in the workup of hypokalemia (low potassium level)?

What is the role of urine osmolality measurement in the diagnosis of hypokalemia (low potassium level)?

What is the role of transtubular potassium gradient (TTKG) in the diagnosis of hypokalemia (low potassium level)?

How is the transtubular potassium gradient (TTKG) measured in patients with hypokalemia (low potassium level)?

What is the role of a basic metabolic profile in the diagnosis of hypokalemia (low potassium level)?

What is the role of serum sodium measurement in the diagnosis of hypokalemia (low potassium level)?

What is the role of sodium bicarbonate measurements in the diagnosis of hypokalemia (low potassium level)?

What is the role of glucose measurements in the diagnosis of hypokalemia (low potassium level)?

What is the role of creatine kinase measurement in the diagnosis of hypokalemia (low potassium level)?

What is the role of magnesium measurements in the diagnosis of hypokalemia (low potassium level)?

What is the role of ABG measurement in the diagnosis of hypokalemia (low potassium level)?

What does alkalosis suggest in patients with hypokalemia (low potassium level)?

What does acidosis suggest in patients with hypokalemia (low potassium level)?

What is the role of ECG in the diagnosis of hypokalemia (low potassium level)?

Which ECG findings suggest hypokalemia (low potassium level)?

What is the role of ECG in the management of hypokalemia (low potassium level)?

Treatment

What are the 4 aspects of treatment of hypokalemia (low potassium level)?

Which medications are used in the treatment of hypokalemia (low potassium level)?

When is surgical intervention indicated in the treatment of hypokalemia (low potassium level)?

How are the causes of hypokalemia (low potassium level) managed to prevent the loss of potassium?

How should potassium be replenished in the treatment of hypokalemia (low potassium level)?

How should potassium be replenished in the treatment of mild or moderate hypokalemia (low potassium level)?

When is IV potassium indicated for the treatment of hypokalemia (low potassium level)?

Do higher dosages of potassium increase the risk of cardiac complications of hypokalemia (low potassium level)?

How is the serum potassium level related to the serum magnesium level in the treatment of hypokalemia (low potassium level)?

What are the limitations of oral potassium therapy in the treatment of hypokalemia (low potassium level)?

How should IV potassium be administered to patients with hypokalemia (low potassium level)?

How should ongoing potassium losses affect the administration of extra potassium?

How should the toxicity of hypokalemia (low potassium level) be monitored?

How are the causes of hypokalemia (low potassium level) managed?

How should treatment of hypokalemia (low potassium level) be individualized?

Which specialist consultations are indicated in the treatment of hypokalemia (low potassium level)?

When is transfer to an intensive care unit indicated in the treatment of hypokalemia (low potassium level)?

Which dietary modifications are indicated in the management of hypokalemia (low potassium level)?

When are activity restrictions indicated in the management of hypokalemia (low potassium level)?

What is the inpatient treatment for hypokalemia (low potassium level)?

What is the role of ECG monitoring in the treatment of severe hypokalemia (low potassium level)?

When is additional evaluation indicated after a diagnosis of hypokalemia (low potassium level)?

How is covert diuretic or laxative use identified in patients with hypokalemia (low potassium level)?

How is hypertension managed in the treatment of hypokalemia (low potassium level)?

What additional tests should be performed if high cortisol levels are detected in patients with hypokalemia (low potassium level)?

What is the role of aldosterone measurement in the management of hypokalemia (low potassium level)?

What is the treatment for hypokalemic metabolic alkalosis?

How is an acute episode of hypokalemia (low potassium level) managed?

What is the follow-up care for patients receiving drugs that may cause hypokalemia (low potassium level)?

How is hypokalemia (low potassium level) prevented?

Medications

What is the role of oral potassium chloride in the management of hypokalemia (low potassium level)?

What is the role of ACE inhibitors in the management of hypokalemia (low potassium level)?

What are the possible adverse effects of ACE inhibitors in patients with hypokalemia (low potassium level)?

How is mild renal insufficiency and hypokalemia (low potassium level) managed?

When are potassium-sparing diuretics indicated in the management of hypokalemia (low potassium level)?

What are the benefits of eplerenone in the treatment of hypokalemia (low potassium level)?

Which medications in the drug class Aldosterone Antagonists, Selective are used in the treatment of Hypokalemia?

Which medications in the drug class Diuretics, Potassium-Sparing are used in the treatment of Hypokalemia?

Which medications in the drug class ARBs are used in the treatment of Hypokalemia?

Which medications in the drug class ACE Inhibitors are used in the treatment of Hypokalemia?

Which medications in the drug class Urinary Alkalinizing Agents are used in the treatment of Hypokalemia?

Which medications in the drug class Electrolytes are used in the treatment of Hypokalemia?