Difference between revisions of "Hypokalemia"

(Intracellular Shift)
Line 22: Line 22:
*[[Hypokalemic periodic paralysis]]
===Decreased intake===
===Decreased intake===
*Special diets or those low in potassium
*Special diets or those low in potassium

Revision as of 19:42, 8 December 2018


Clinical Features

Differential Diagnosis

Differential diagnosis of hypokalemia

Intracellular Shift

Decreased intake

  • Special diets or those low in potassium
  • Chronic alcohol abuse

Increased loss



ECG Hypokalemia.jpg


  • Potassium repletion (PO or IV)
    • Every 10mEq KCl → serum K ↑ ~0.1mEq/L
    • PO preferred (if symptomatic or level is <2.5, both oral and IV should be given)
  • Oral potassium
    • Inexpensive and rapidly absorbed
    • KCl tablet (elixir form available but has poor taste)
    • K-Dur (extended release tablet) is large and may be difficult to swallow
  • Intravenous potassium
    • Must be given in dilute solutions at slow rate (10meq/hour) to minimize side effects and cardiac toxicity
    • Generally should not give more than 40mEq via IV
    • Side effects: Local tissue burning, phelbitis, sclerosis
  • Also treat Hypomagnesemia if present
  • Re-check ECG after treatment [1]
  • Hypokalemia in acute or recent myocardial infarction places patients at much higher risk for ventricular fibrillation[2]
    • Previous studies and many professional organizations recommend maintaining K between 4.0 - 5.0 mEq/L in MI patients
    • However, more recent studies suggest 3.5 - 4.5 mEq/L results in the lowest mortality


  • Based on underlying cause

See Also

External Links


  1. Slovis, Corey. "Electrolyte Emergencies". Presentation.
  2. Goyal A et al. Serum Potassium Levels and Mortality in Acute Myocardial Infarction. JAMA. 2012;307(2):157-164.