BASICS
- Serum potassium <3.5 mEq/L (normal 3.5β5 mEq/L)
- Severity:
- Mild: 3.0β3.5 mEq/L
- Moderate: 2.5β3.0 mEq/L
- Severe: <2.5 mEq/L
EPIDEMIOLOGY
- Male = female prevalence
- Common in >20% hospitalized patients (<3.6 mEq/L)
- Higher prevalence in alcoholism, diuretic use, CKD, eating disorders, AIDS
- Risk increased post bariatric surgery
ETIOLOGY AND PATHOPHYSIOLOGY
- Decreased intake: poor diet (alcoholics, elderly), anorexia nervosa
- GI losses: vomiting, diarrhea, laxative abuse, fistulas, bowel diversion, malabsorption
- Intracellular shift: metabolic alkalosis, insulin excess, Ξ²2-agonists, hypokalemic periodic paralysis, toxins, refeeding syndrome, exercise
- Renal potassium loss:
- Drugs: loop and thiazide diuretics, amphotericin B, aminoglycosides, penicillins, clay
- Mineralocorticoid excess (primary hyperaldosteronism, secondary causes, exogenous mineralocorticoids)
- Osmotic diuresis (e.g., uncontrolled diabetes)
- Renal tubular acidosis types I & II
- Magnesium depletion
- Glucocorticoid excess (Cushing syndrome, exogenous steroids, ectopic ACTH)
- DKA treatment with inadequate potassium replacement
- Genetic syndromes:
- 11-Ξ²-hydroxysteroid dehydrogenase deficiency
- Apparent mineralocorticoid excess
- Congenital adrenal syndromes
- Familial hypokalemic periodic paralysis
- Bartter, Gitelman, Liddle syndromes
RISK FACTORS
- Higher systolic BP
- Diuretic use (thiazide, loop), ACE inhibitors
- Low cholesterol, low BMI
- Higher albumin-to-creatinine ratio
PREVENTION
- Monitor potassium levels when starting diuretics
- Address underlying causes and medication review
COMMON ASSOCIATED CONDITIONS
- Acute GI illnesses with vomiting/diarrhea
- Cardiac arrhythmias
- Predictor of severe alcohol withdrawal syndrome
DIAGNOSIS
History
- Diuretic use, malnutrition, GI losses
- Symptoms: fatigue, cramps, muscle weakness
- Polyuria, polydipsia, nocturia, heart failure symptoms
Physical Exam
- Skeletal muscle weakness (proximal > distal)
- GI hypomotility
- Respiratory muscle weakness (risk respiratory failure)
- Cardiovascular signs: hypotension, arrhythmias
- Renal manifestations
Differential Diagnosis
- Mainly lab diagnosis, exclude lab errors (e.g., leukocytosis)
Diagnostic Tests
- Serum potassium <3.5 mEq/L
- ECG: T wave flattening, U waves, arrhythmias
- Urine potassium and chloride to differentiate renal vs nonrenal loss
- Basic metabolic panel with Mg, Ca, phosphate
- ABG for acid-base status
- Serum digoxin level if relevant
- Creatine kinase for rhabdomyolysis
- Drug screens if suspicion
Interpretation
- Urine potassium >15 mEq/day or spot urine K/Cr ratio >13 mEq/g suggests renal loss
- TTKG >4 suggests renal potassium wasting
- Metabolic acidosis with low urine K β GI loss
- Metabolic alkalosis with urine K wasting β primary aldosteronism, diuretics, genetic syndromes
TREATMENT
General Measures
- Correct underlying cause
- Stop laxatives, use K-neutral or K-sparing diuretics
- Treat diarrhea, vomiting
- H2 blockers for nasogastric suction patients
- Control hyperglycemia if present
Medication
- Oral potassium preferred for stable patients (40β120 mEq/day in divided doses)
- Hydration with water to reduce GI irritation
- IV potassium for inability to tolerate oral or severe cases; max 10 mEq/hr peripheral, central line preferred >10 mEq/hr
- Potassium chloride is preferred salt form
- Magnesium replacement if hypomagnesemia present
Precautions
- Monitor serum K closely to avoid hyperkalemia
- More frequent checks in elderly, diabetics, renal failure patients
- Insulin therapy in DKA requires aggressive potassium replacement
GERIATRIC CONSIDERATIONS
- Elderly develop hypokalemia rapidly
- Risk of paralysis, myonecrosis, falls
ISSUES FOR REFERRAL
- Unexplained hypokalemia
- Suspected aldosteronism or periodic paralysis
- Refractory hypokalemia
ADMISSION CONSIDERATIONS
- Cardiac manifestations or respiratory failure require inpatient care with cardiac monitoring
- ICU care for life-threatening complications
ONGOING CARE
- Monitor potassium and magnesium frequently during replacement
- Adjust therapy based on clinical status and compliance
DIET
- Increase potassium-rich foods: bananas, oranges, cantaloupe, prunes, dried fruits, beans, squash
- Reduce sodium intake to minimize urinary potassium loss
PATIENT EDUCATION
- Importance of adherence to supplements and diet
- Awareness of symptoms and when to seek care
PROGNOSIS
- Usually corrects in 24β72 hours after replacement
- Resolves with treatment of primary cause
- Associated with increased morbidity/mortality if cardiac arrhythmias occur
COMPLICATIONS
- Hyperkalemia from overcorrection
- Digoxin toxicity potentiation
- Arrhythmias due to altered cardiac cell excitability
REFERENCES
- Palmer BF. A physiologic-based approach to the evaluation of a patient with hypokalemia. Am J Kidney Dis. 2010;56(6):1184-1190.
- Kardalas E, Paschou SA, Anagnostis P, et al. Hypokalemia: a clinical update. Endocr Connect. 2018;7(4):R135-R146.
- Asmar A, Mohandas R, Wingo CS. A physiologic-based approach to the treatment of a patient with hypokalemia. Am J Kidney Dis. 2012;60(3):492-497.
- Kovesdy CP, Matsushita K, Sang Y, et al. Serum potassium and adverse outcomes across the range of kidney function: a CKD Prognosis Consortium meta-analysis. Eur Heart J. 2018;39(17):1535-1542.
- Unwin RJ, Luft FC, Shirley DG. Pathophysiology and management of hypokalemia: a clinical perspective. Nat Rev Nephrol. 2011;7(2):75-84.
Clinical Pearls
- Even mild to moderate hypokalemia in cardiac patients increases arrhythmia risk; repletion and monitoring critical.
- Correct hypomagnesemia to effectively treat hypokalemia.
- Young women with unexplained hypokalemia should be evaluated for bulimia nervosa.
- Supplement potassium when prescribing diuretics; minimize dose of non-potassium-sparing diuretics.