Fig. 27.1 Reproduced with permissions from The Permanente Journal [1]
Causes:
- (a)
Inadequate intake: diet and alcoholism.
- (b)
Excessive renal loss: mineralocorticoid excess, Cushing’s syndrome, diuretics, hydrochlorothiazide and furosemide therapy, carbonic anhydrase inhibitors, chronic metabolic alkalosis, renal tubular acidosis, and ureterosigmoidostomy.
- (c)
- (d)
β-Adrenergic agonists, insulin, and alkalosis (respiratory and metabolic) shift potassium to the intracellular space.
- (e)
The most common renal cause of hypokalemia is diuretic therapy when loop diuretics and thiazides are co-prescribed. Loop diuretics block the sodium-potassium-chloride cotransporter in the thick ascending limb of the loop of Henle, while thiazides block the sodium-chloride cotransporter in the distal convoluted tubule [4].
Hypokalemia treatment consists of oral or intravenous replacement of potassium.
Mild hypokalemia (>2.0 mEq/L): infuse potassium chloride up to 10 mEq/h ivFull access? Get Clinical Tree