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Hypokalemia

Sibley Strader, MD, ABFM Reviewed 05/2023
 


BASICS

DESCRIPTION

A serum potassium concentration <3.5 mEq/L (normal range, 3.5 to 5 mEq/L). 
  • Mild: 3 to 3.5 mEq/L

  • Moderate: 2.5 to 3 mEq/L

  • Severe: <2.5 mEq/L

EPIDEMIOLOGY

Predominant sex: male = fem...

DIAGNOSIS

  • Usually asymptomatic until serum potassium is below 3.0 mEq/L, unless it falls rapidly or patient has potentiating factor, for example, disposition to arrhythmia

  • Signs and symptoms mainly inv...

TREATMENT

  • Reduce potassium loss.

  • Replenish stored potassium.

  • Evaluate potential toxicities.

  • Determine cause.

GENERAL MEASURES

  • Manage underlying disease or eliminate causative factor.

    • Discontinue laxative, u...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Patients receiving IV therapy should have continuous cardiac monitoring and serum potassium level monitored 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...

ADDITIONAL READING

  • Skogestad J, Aronsen JM. Hypokalemia-induced arrhythmias and heart failure: new insights and implications for therapy. Front Physiol. 2018;9:1500.

  • ...

SEE ALSO

  • Hyperkalemia

  • Algorithm: Hypokalemia

CODES

ICD10

  • E87.6 Hypokalemia

SNOMED

  • 237853005 Drug-induced hypokalemia

  • 43339004 Hypokalemia

  • 61120003 Acute hypokalemia

  • 10469003 Chronic hypokalemia

  • 81987005 Familial hypokalemic alkalosis, Gullner type

  • 40558...

CLINICAL PEARLS

  • In patients with cardiac ischemia, heart failure, or left ventricular hypertrophy, even mild to moderate hypokalemia can cause arrhythmias. These patients should receive potassium repl...

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