Hypokalemia history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Aida Javanbakht, M.D. Cafer Zorkun, M.D., Ph.D. [2]; Assistant Editor(s)-In-Chief: Jack Khouri
History and Symptoms
History
A detailed history can help depict the cause of hypokalemia.
Dietary History
Malnutrition: lack of meat and fruit intake
Medication History
- Diuretics (loop and thiazides)
- Beta-agonists
- Chloroquine
- Theophylline
- Insulin
- Corticosteroids
- Licorice
- Nephrotoxic drugs (platinum-based chemotherapy, aminoglycosides)
- Laxatives
Past Medical History
- Uncontrolled diabetes
- Hyperthyroidism
- Pernicious anemia
- COPD (treated with Beta agonists and theophylline)
- Cushing’s disease
- Periodic paralysis
- Ileostomy/short bowel
- Primary hyperaldosteronism
- Liddle syndrome
- Bartter and Gitelman syndrome
- Prolonged starvation
- Cancer
- Renal tubular acidosis type I and type II
Symptoms
The severity of symptoms depends on the degree of hypokalemia, but keep in mind that there is marked individual variability [1][2][3][4].
Constitutional
- Fatigue
- Weakness
- Vomiting
- Constipation
- Muscle cramps and paralysis (the lower extremity muscles are most commonly involved) which may involve the intestine and cause ileus
- Respiratory muscle weakness leading to respiratory failure.
Cardiac
- Hypertension
- Arrhythmias including premature atrial and ventricular complexes, paroxysmal atrial or junctional tachycardia and even ventricular tachycardia or fibrillation
- Heart block
- Digoxin therapy, CAD and left ventricular hypertrophy potentiate hypokalemia effects on the heart
Renal
- Nephrogenic diabetes insipidus due to decreased concentrating ability. As a consequence, the patient presents with polyuria and polydipsia
- Increased bicarbonate reabsorption
- Increased ammonia formation which may precipitate hepatic encephalopathy in cirrhotic patients
- Decreased sodium reabsorption resulting in hyponatremia
Other
References
- ↑ Wojtaszek E, Matuszkiewicz-Rowińska J (2013). "[Hypokalemia]". Wiad. Lek. (in Polish). 66 (4): 290–3. PMID 24490479.
- ↑ Wen Z, Chuanwei L, Chunyu Z, Hui H, Weimin L (April 2013). "Rhabdomyolysis presenting with severe hypokalemia in hypertensive patients: a case series". BMC Res Notes. 6: 155. doi:10.1186/1756-0500-6-155. PMC 3637555. PMID 23594380.
- ↑ Gaduputi V, Chandrala C, Abbas N, Tariq H, Chilimuri S, Balar B (2014). "Prognostic significance of hypokalemia in hepatic encephalopathy". Hepatogastroenterology. 61 (133): 1170–4. PMID 25436277.
- ↑ Mirijello A, Rinninella E, De Leva F, Tosoni A, Vassallo G, Antonelli M, Addolorato G, Landolfi R (March 2014). "Hypokalemia-induced pseudoischemic electrocardiographic changes and quadriplegia". Am J Emerg Med. 32 (3): 286.e1–4. doi:10.1016/j.ajem.2013.09.033. PMID 24176583.