Magnesium is required for adequate processing of potassium. A low level of magnesium in the blood can also cause hypokalemia.In addition to urinary losses from polyuria and volume contraction, also an obligate loss of potassium from kidney tubules occurs as a cationic partner to the negatively charged ketone, β-hydroxybutyrate. Hypokalemia is observed with low total body potassium and a low intracellular concentration of potassium. A special case of potassium loss occurs with diabetic ketoacidosis.Diuretic abuse among athletes and people with eating disorders may present with hypokalemia due to urinary potassium loss. Other medications such as the antifungal amphotericin B or the cancer drug cisplatin can also cause long-term hypokalemia. hydrochlorothiazide) commonly cause hypokalemia. Blood pressure medications such as loop diuretics (e.g. Certain medications can cause excess potassium loss in the urine.(See discussion of alkalosis below.) Other gastrointestinal causes include pancreatic fistulae and the presence of adenoma. Rather, heavy urinary losses of K + in the setting of post- emetic bicarbonaturia force urinary potassium excretion. Vomiting can also cause hypokalemia, although not much potassium is lost from the vomitus. Typically, this is a consequence of diarrhea, excessive perspiration, losses associated with crush injury, or surgical procedures.
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Gastrointestinal or skin loss Ī more common cause is excessive loss of potassium, often associated with heavy fluid losses that flush potassium out of the body. This is a rare cause and may occur in those with anorexia nervosa or those on a ketogenic diet. Not eating a diet with enough potassium-containing foods or fasting can cause the gradual onset of hypokalemia. Hypokalemia can result from one or more of these medical conditions: Psychological symptoms associated with severe hypokalemia can include delirium, hallucinations, depression, or psychosis. Respiratory depression from severe impairment of skeletal muscle function is found in some people.
Reports exist of rhabdomyolysis occurring with profound hypokalemia with serum potassium levels less than 2 meq/L. With more severe hypokalemia, flaccid paralysis and hyporeflexia may result. Severe hypokalemia, with serum potassium concentrations of 2.5–3 meq/L (Nl: 3.5–5.0 meq/L), may cause muscle weakness, myalgia, tremor, and muscle cramps (owing to disturbed function of skeletal muscle), and constipation (from disturbed function of smooth muscle). Mild hypokalemia is often without symptoms, although it may cause elevation of blood pressure, and can provoke the development of an abnormal heart rhythm. The word hypokalemia comes from hypo- 'under' + kalium 'potassium' + -emia 'blood condition'.
It affects about 20% of people admitted to hospital. Hypokalemia is one of the most common water–electrolyte imbalances. Magnesium replacement may also be required. Hypokalaemia, hypopotassaemia, hypopotassemiaĪn ECG in a person with a potassium level of 1.1 meq/L showing the classical changes of ST segment depression, inverted T waves, large U waves, and a slightly prolonged PR interval.įeeling tired, leg cramps, weakness, constipation, abnormal heart rhythm ĭiarrhea, medications like furosemide and steroids, dialysis, diabetes insipidus, hyperaldosteronism, hypomagnesemia, not enough intake in the diet īlood potassium 40 mmol/L) should generally be given using a central venous catheter.
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