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Hypokalemia

Synonym: low potassium
German: Hypokaliämie

1 Definition

Hypokalemia is defined as a serum potassium level below 3.6 mmol/l.

2 Etiology

There are several mechanisms that can lead to hypokalemia:

  • Increased secretion, with the possibilities of:
  • Migration of potassium into the intracellular space: a condition that can appear due to alkalosis or insulin therapy
  • Increased usage: in case of increased cell formation, e.g. highly elevated erythropoiesis (rare)
  • Lack of potassium intake: caused by extreme malnutrition (very rare)

3 Symptoms

The symptoms of hypokalemia are determined by the electrophysiological consequences of low potassium. The resulting hyperpolarization leads to a reduced neuromuscular excitability and thus causes:

Other consequences of hypokalemia are metabolic alkaloses and hypokalemic nephropathy.

4 Diagnosis

The most important diagnostic method is to determine the serum potassium level, followed by searching for the underlying cause (medication history, determining aldosterone levels, etc.).

5 Therapy

Firstly, the cause of the condition has to be treated. In addition, a normalization of potassium levels should happen as quickly as possible.

Mild forms of hypokalemia can be compensated by a diet high in potassium (bananas, fruit juices) or by gastro-resistent potassium supplements. When taking potassium chloride effervescent tablets, it should be considered that potassium salts corrode the gastric mucosa.

Severe forms should be treated by parenterally supplying potassium chloride while monitoring ECG and potassium level changes. This method bears the risk of hyperkalemia. The maximum daily allowance of potassium chloride is 3 mmol per kg body weight, whereby only 20 mmol/hour should be supplied.

see also: hyperkalemia

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