Hypokalemia

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Background

Low = <3.5meq/L

Low! = <2.5meq/L


Diagnosis

Symptoms:

1) CNS (weakness, cramps, hyporeflexia)

2) GI (ileus)

3) CV (dysrhythmia, dig tox, U waves, ST depression, prolonged QT)

4) Renal (met alkalosis)

DDX

A. Shift

  • Increased pH
  • B-agonist, inuslin

B. Reduced intake

C. Increased loss

  • Renal
    • Primary (hyperaldos, osmotic diuresis)
    • Secondary (diuretics, malignant HTN, renal art stenosis)
    • Misc
      • Licorice
      • HyperCa
      • HypoMg
      • RTA
      • Leukemia

D. Drugs

  • PCN
  • Lithium
  • L-dopa
  • Theophyline

E. GI Loss (v/d/fistula)

Treatment

20meq/h KCl IV or PO

every 10meq should inc serum by ~0.1meq/L)

  • treat hypomag if present

Source

2/7/06 DONALDSON (adapted from Tintinalli)

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