HYPOKALEMIA

HYPOKALEMIA Hypokalemia Serum Potassium < 3.5 mmol/L Increased Loss Renal Loss Urine loss > 20 mmol/d High distal [K] TTKG > 4 High distal flow TTKG < 4 Polyuria Volume Status Assessment EABV contracted • Loop diuretics / Bartter’s syndrome • Thiazide diuretics / Gitelman’s syndrome • Magnesium depletion Normal or expanded EABV High renin, High aldosterone • Renal artery stenosis Low renin, High aldosterone • Hyperaldosteronism Low renin, Low aldosterone • Licorice intake • Liddle’s syndrome Decreased intake (rare cause in isolation) GI loss Urine loss < 20 mmol/d • Diarrhea • Vomiting • NG suction • Laxatives Transcellular shift • Insulin • β₂ agonists • Alkalemia • Refeeding syndrome • Rapid hematopoiesis • Hypothermia • Thyrotoxic periodic paralysis / familial hypokalemic periodic paralysis