Hypokalemia: a clinical update

doi:10.1530/EC-18-0109

Review

. 2018 Apr;7(4):R135-R146.

doi: 10.1530/EC-18-0109. Epub 2018 Mar 14.

Hypokalemia: a clinical update

Efstratios Kardalas¹, Stavroula A Paschou², Panagiotis Anagnostis³, Giovanna Muscogiuri⁴, Gerasimos Siasos⁵, Andromachi Vryonidou⁶

Affiliations

¹ Department of Endocrinology and DiabetesEvangelismos Hospital, Athens, Greece.
² Division of Endocrinology and Diabetes'Aghia Sophia' Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
³ Unit of Reproductive EndocrinologyFirst Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
⁴ Division of EndocrinologyDepartment of Clinical Medicine and Surgery, 'Federico II' University of Naples, Naples, Italy.
⁵ First Department of CardiologyHippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
⁶ Department of Endocrinology and DiabetesHellenic Red Cross Hospital, Athens, Greece [email protected].

PMID: 29540487
PMCID: PMC5881435
DOI: 10.1530/EC-18-0109

Review

Hypokalemia: a clinical update

Efstratios Kardalas et al. Endocr Connect. 2018 Apr.

. 2018 Apr;7(4):R135-R146.

doi: 10.1530/EC-18-0109. Epub 2018 Mar 14.

Authors

Efstratios Kardalas¹, Stavroula A Paschou², Panagiotis Anagnostis³, Giovanna Muscogiuri⁴, Gerasimos Siasos⁵, Andromachi Vryonidou⁶

Affiliations

¹ Department of Endocrinology and DiabetesEvangelismos Hospital, Athens, Greece.
² Division of Endocrinology and Diabetes'Aghia Sophia' Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
³ Unit of Reproductive EndocrinologyFirst Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
⁴ Division of EndocrinologyDepartment of Clinical Medicine and Surgery, 'Federico II' University of Naples, Naples, Italy.
⁵ First Department of CardiologyHippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
⁶ Department of Endocrinology and DiabetesHellenic Red Cross Hospital, Athens, Greece [email protected].

PMID: 29540487
PMCID: PMC5881435
DOI: 10.1530/EC-18-0109

Abstract

Hypokalemia is a common electrolyte disturbance, especially in hospitalized patients. It can have various causes, including endocrine ones. Sometimes, hypokalemia requires urgent medical attention. The aim of this review is to present updated information regarding: (1) the definition and prevalence of hypokalemia, (2) the physiology of potassium homeostasis, (3) the various causes leading to hypokalemia, (4) the diagnostic steps for the assessment of hypokalemia and (5) the appropriate treatment of hypokalemia depending on the cause. Practical algorithms for the optimal diagnostic, treatment and follow-up strategy are presented, while an individualized approach is emphasized.

Keywords: acid–base status; adrenal; electrolytes; hypokalemia; kidneys; potassium.

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Figures

**Figure 2**
Algorithm of the diagnostic approach to a patient with hypokalemia.

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References

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[1] Ashurst J, Sergent SR, Wagner BJ, Kim J. Evidence-based management of potassium disorders in the emergency department (digest). Emergency Medicine Practice 2016. 2 18. - PubMed

[2] Ashurst J, Sergent SR, Wagner BJ, Kim J. Evidence-based management of potassium disorders in the emergency department (digest). Emergency Medicine Practice 2016. 2 18. - PubMed

[3] Elliott TL Electrolytes: Potassium Disorders. FP Essentials 2017. 459 21–28. - PubMed

[4] Elliott TL Electrolytes: Potassium Disorders. FP Essentials 2017. 459 21–28. - PubMed

[5] Weir MR, Rolfe M. Potassium homeostasis and renin-angiotensin-aldosterone system inhibitors. Clinical Journal of the American Society of Nephrology 2010. 5 531–548. (10.2215/CJN.07821109) - DOI - PubMed

[6] Weir MR, Rolfe M. Potassium homeostasis and renin-angiotensin-aldosterone system inhibitors. Clinical Journal of the American Society of Nephrology 2010. 5 531–548. (10.2215/CJN.07821109) - DOI - PubMed

[7] McDonough AA, Youn JH. Potassium homeostasis: the knowns, the unknowns, and the health benefits. Physiology 2017. 32 100–111. (10.1152/physiol.00022.2016) - DOI - PMC - PubMed

[8] McDonough AA, Youn JH. Potassium homeostasis: the knowns, the unknowns, and the health benefits. Physiology 2017. 32 100–111. (10.1152/physiol.00022.2016) - DOI - PMC - PubMed

[9] Houston MC, Harper KJ. Potassium, magnesium, and calcium: their role in both the cause and treatment of hypertension. Journal of Clinical Hypertension 2008. 10 3–11. (10.1111/j.1751-7176.2008.08575.x) - DOI - PMC - PubMed

[10] Houston MC, Harper KJ. Potassium, magnesium, and calcium: their role in both the cause and treatment of hypertension. Journal of Clinical Hypertension 2008. 10 3–11. (10.1111/j.1751-7176.2008.08575.x) - DOI - PMC - PubMed

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Hypokalemia: a clinical update

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Hypokalemia: a clinical update

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