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Hypokalemia

James Auteri Ferguson, MD, MPH, CPH and Jason Chao, MD, MS Reviewed 06/2019
 


BASICS

DESCRIPTION

Hypokalemia is defined as a serum potassium concentration <3.5 mEq/L (normal range, 3.5 to 5.0 mEq/L). 
  • Mild hypokalemia (serum potassium 3.0 to 3.5 mEq/L)

  • Moderate hypokalemia (ser...

DIAGNOSIS

  • Patients with hypokalemia often have no symptoms, especially if the hypokalemia is mild (serum potassium 3.0 to 3.5 mEq/L).

  • Neuromuscular (most prominent manifestations)

    • Easy fatigability, cra...

TREATMENT

GENERAL MEASURES

  • Underlying cause of hypokalemia should be identified.

  • For asymptomatic patients treated with oral replacement, outpatient follow-up is sufficient.

  • Patients with cardiac manifes...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Patients receiving IV therapy should have cardiac monitoring and serum potassium level checked frequently (q4–6h).

  • Patients requiring potassium s...

REFERENCES

1
Palmer BF. A physiologic-based approach to the evaluation of a patient with hypokalemia. Am J Kidney Dis.  2010;56(6):1184–1190. [View Abstract on OvidMedline]
2
Asmar A, Mohandas R, Wi...

ADDITIONAL READING

  • Ben Salem C, Hmouda H, Bouraoui K. Drug-induced hypokalaemia. Curr Drug Saf.  2009;4(1):55–61. [View Abstract on OvidMedline]

  • Ernst ME, Moser M. Use of diuretics in patients wit...

CODES

ICD10

E87.6 Hypokalemia 

ICD9

276.8 Hypopotassemia 

SNOMED

  • 43339004 hypokalemia (disorder)

  • 22774003 Hypokalemic alkalosis (disorder)

  • 237851007 Hypokalemic acidosis (disorder)

  • 237853005 Drug-induced hypo...

CLINICAL PEARLS

  • In patients without heart disease, a mildly low potassium level will rarely cause cardiac disturbances. In an otherwise healthy patient, gentle repletion using oral potassium or an inc...

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