Potassium Disorders: Hypokalemia and Hyperkalemia.

Published

Journal Article

Hypokalemia and hyperkalemia are common electrolyte disorders caused by changes in potassium intake, altered excretion, or transcellular shifts. Diuretic use and gastrointestinal losses are common causes of hypokalemia, whereas kidney disease, hyperglycemia, and medication use are common causes of hyperkalemia. When severe, potassium disorders can lead to life-threatening cardiac conduction disturbances and neuromuscular dysfunction. Therefore, a first priority is determining the need for urgent treatment through a combination of history, physical examination, laboratory, and electrocardiography findings. Indications for urgent treatment include severe or symptomatic hypokalemia or hyperkalemia; abrupt changes in potassium levels; electrocardiography changes; or the presence of certain comorbid conditions. Hypokalemia is treated with oral or intravenous potassium. To prevent cardiac conduction disturbances, intravenous calcium is administered to patients with hyperkalemic electrocardiography changes. Insulin, usually with concomitant glucose, and albuterol are preferred to lower serum potassium levels in the acute setting; sodium polystyrene sulfonate is reserved for subacute treatment. For both disorders, it is important to consider potential causes of transcellular shifts because patients are at increased risk of rebound potassium disturbances.

Full Text

Duke Authors

Cited Authors

  • Viera, AJ; Wouk, N

Published Date

  • September 15, 2015

Published In

Volume / Issue

  • 92 / 6

Start / End Page

  • 487 - 495

PubMed ID

  • 26371733

Pubmed Central ID

  • 26371733

Electronic International Standard Serial Number (EISSN)

  • 1532-0650

Language

  • eng

Conference Location

  • United States