Hypokalemia differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Differentiating Causes of Hypokalemia

Differentiating the diseases that can cause hypokalemia is as following:

Diseases		Clinical manifestations									Para-clinical findings							Gold standard	Additional findings
		Symptoms					Physical examination
											Lab Findings				Imaging
		Fatigue	Fever	Urinary symptoms			Blood Pressure	Skin lesions	Edema	Other	ABG	Electrolytes	Urinalysis	Other	Ultrasonography	CT scan	Other
				Polyuria	Oliguria	Nocturia
Renal and adrenal disorders	Bartter syndrome	+	-	+	-	+/-	Normal or ↓	-	-	-	Metabolic alkalosis	↓K	↑K, ↑Ca, ↑Cl	-	Normal		-		Mental retardation, Sensorineural hearing loss
	Gitelman syndrome	+	-	+	-	+	Normal	-	-	-	Metabolic alkalosis	↓K	↑K, ↓Ca, ↑Cl	-	Normal		-		Growth retardation, Tetany, Muscle cramp
	Liddle syndrome	-	-	+/-	-	-	↑	-	+/-		Metabolic alkalosis	↓K	↑K, ↓Na	↓Plasma renin activity (PRA), ↓Plasma aldosterone concentration (PAC)			-		Pseudohyperaldosteronism
	Diuretic use
	Hemodialysis
	Primary hyperaldosteronism
	Cushing syndrome
Gastrointestinal disorders	GI bleeding
	Vomiting
	Severe diarrhea
	Villous adenoma
	VIPoma
Neuropsychiatric disorders	Hypokalemic periodic paralysis
	Central diabetes insipidus
	Bulimia nervosa
	Anorexia nervosa
	Primary polydipsia
Systemic diseases	Hypothermia
	Alcoholism
	Diabetic ketoacidosis
	Hypothermia
	Hypomagnesemia
	Burns
	Cystic fibrosis

References

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