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Hypokalemia

James A. Ferguson, MD, MPH and Jason Chao, MD, MS Reviewed 06/2018
 


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)

    • Skeletal muscle weak...

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
Hanlon JT, Semla TP, Schmader KE. Medication misadventures in older adults: literature from 2013. J Am Geriatr Soc.  2014;62(10):1950–1953. [View Abstract on OvidMedline]
2
Krijthe BP,...

ADDITIONAL READING

  • 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. [View Abstract on OvidMedline...

SEE ALSO

  • Hyperkalemia

  • Algorithm: Hypokalemia

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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