Hypokalemia

Hypokalemia is a topic covered in the Diagnosaurus.

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Etiology

Decreased potassium intake Potassium shift into cell

  • Insulin excess, eg, postprandial
  • Alkalosis
  • Beta-adrenergic agonists
  • Trauma (possibly via epinephrine)
  • Hypokalemic periodic paralysis
Renal potassium loss Increased aldosterone (mineralocorticoid) effects
  • Primary hyperaldosteronism
  • Secondary hyperaldosteronism (dehydration, heart failure)
  • Renovascular or malignant hypertension
  • Cushing's syndrome
  • European licorice (inhibits cortisol)
  • Renin-producing tumor
  • Congenital abnormality of steroid metabolism (eg, adrenogenital syndrome, 17?-hydroxylase defect)
Increased flow of distal nephron
  • Diuretics (furosemide, thiazides)
  • Salt-losing nephropathy
Hypomagnesemia
  • Unreabsorbable anion
  • Carbenicillin, penicillin
Renal tubular acidosis (type I or II)
  • Fanconi's syndrome
  • Interstitial nephritis
  • Metabolic alkalosis (bicarbonaturia)
Genetic disorder of the nephron
  • Bartter's syndrome
  • Liddle's syndrome
Extrarenal potassium loss
  • Vomiting, diarrhea, laxative abuse
  • Villous adenoma, Zollinger-Ellison syndrome (gastrinoma)

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Etiology

Decreased potassium intake Potassium shift into cell

  • Insulin excess, eg, postprandial
  • Alkalosis
  • Beta-adrenergic agonists
  • Trauma (possibly via epinephrine)
  • Hypokalemic periodic paralysis
Renal potassium loss Increased aldosterone (mineralocorticoid) effects
  • Primary hyperaldosteronism
  • Secondary hyperaldosteronism (dehydration, heart failure)
  • Renovascular or malignant hypertension
  • Cushing's syndrome
  • European licorice (inhibits cortisol)
  • Renin-producing tumor
  • Congenital abnormality of steroid metabolism (eg, adrenogenital syndrome, 17?-hydroxylase defect)
Increased flow of distal nephron
  • Diuretics (furosemide, thiazides)
  • Salt-losing nephropathy
Hypomagnesemia
  • Unreabsorbable anion
  • Carbenicillin, penicillin
Renal tubular acidosis (type I or II)
  • Fanconi's syndrome
  • Interstitial nephritis
  • Metabolic alkalosis (bicarbonaturia)
Genetic disorder of the nephron
  • Bartter's syndrome
  • Liddle's syndrome
Extrarenal potassium loss
  • Vomiting, diarrhea, laxative abuse
  • Villous adenoma, Zollinger-Ellison syndrome (gastrinoma)

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