Hypokalemia is a condition.

Written by Li Fang Fang

Hematology

Updated on November 18, 2024

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Hypokalemia is classified as an electrolyte disorder. When suffering from hypokalemia, patients may experience general weakness and poor appetite. In severe cases, paralysis of the limbs may occur. There are certain causes of hypokalemia, which can be divided into three types. One is reduced intake, the second is excessive loss, and the third is abnormal distribution. Reduced intake mainly refers to patients with poor diets; excessive loss is common in patients with infections, diarrhea, and those who excrete a high amount of potassium in their urine; abnormal distribution refers to potassium moving from the extracellular space into cells, causing hypokalemia.

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Written by Wei Shi Liang

Intensive Care Unit

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Causes of Hypokalemia

Common causes of hypokalemia include insufficient intake or prolonged inability to eat without intravenous supplementation. In such cases, while intake of potassium decreases, the kidneys continue to excrete potassium, leading to a loss of potassium in the blood. Additionally, increased excretion can cause hypokalemia, including losses from the gastrointestinal tract such as vomiting, diarrhea, and continuous gastrointestinal decompression, which results in a loss of digestive fluids rich in potassium. Potassium loss through the kidneys from prolonged use of potassium-wasting diuretics or during the polyuric phase of acute renal failure can also lead to hypokalemia. Furthermore, the shift of potassium from outside to inside the cells can cause hypokalemia.

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Endocrinology

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Why is the urine acidic in hypokalemia?

When hypokalemia occurs, the concentration of potassium ions in the extracellular fluid decreases, causing potassium ions to shift from the inside to the outside of the cell. Meanwhile, two sodium ions and one hydrogen ion from the extracellular fluid move into the cell, decreasing the concentration of hydrogen ions outside the cell, thus resulting in metabolic alkalosis. At the same time, due to the reduction of blood potassium, the potassium-sodium exchange in the renal tubules is reduced. The renal tubule cells exchange more hydrogen ions and sodium ions, thus increasing the reabsorption of bicarbonate ions and raising the pH value. This type of metabolic alkalosis increases the number of hydrogen ions inside cells, while the kidney secretes more hydrogen, thereby producing acidic urine, also known as paradoxical aciduria.

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Written by Wei Shi Liang

Intensive Care Unit

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Can people with hypokalemia smoke?

Hypokalemia is not directly related to smoking. However, once hypokalemia occurs, there is definitely an underlying disease. In the case that the primary disease is not controlled, it is advisable to avoid smoking. Potassium is an essential electrolyte for life, and its physiological functions mainly include maintaining cellular metabolism, regulating osmotic pressure, acid-base balance, and maintaining cell stress functions. Once hypokalemia occurs, active treatment should be implemented, primarily addressing the primary disease, symptomatic treatment with potassium supplementation, and avoiding the occurrence of hyperkalemia. The principle of potassium supplementation is that for mild hypokalemia without clinical manifestations, oral potassium should be given; in cases of severe hypokalemia, intravenous potassium supplementation should be administered immediately. Intravenous potassium should ideally not use peripheral veins but establish a central vein, and the speed of potassium supplementation and the monitoring of potassium levels should be controlled.

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Written by Wei Shi Liang

Intensive Care Unit

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What medicine should be taken for hypokalemia?

The treatment of hypokalemia primarily involves addressing the underlying disease. Symptomatic treatment should avoid excessive potassium supplementation, which can lead to hyperkalemia. The principle of potassium supplementation is as follows: for mild hypokalemia, such as in patients showing clinical signs, oral potassium can be administered at 40-80 millimoles per day. For patients with severe hypokalemia, or those whose gastrointestinal tract cannot utilize potassium, with potassium levels less than 2.0 millimoles per liter, intravenous potassium can be provided. An initial supplementation rate of 10-20 millimoles per hour is relatively safe. In cases of severe hypokalemia with life-threatening clinical signs, a rapid increase to 40-80 millimoles can be achieved in a short period, but close monitoring is necessary.

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Written by Gan Jun

Endocrinology

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What should I do if hypokalemia suddenly occurs?

Hypokalemia is very common in clinical settings, generally caused by improper diet, insufficient supplementation, or excessive loss. It is recommended that patients first seek further examination at a hospital. If potassium deficiency is confirmed, mild cases can be treated with oral potassium supplements, while moderate to severe cases who experience muscle weakness, flaccid paralysis, and arrhythmias should receive intravenous potassium supplementation in conjunction with oral treatment. It is also important to dynamically monitor electrolyte levels. In daily life, it is important to plan a diet that is rich in vitamins and trace elements, and treat the specific causes of the condition. It is recommended that patients continually monitor their fluid and electrolyte balance, abstain from smoking and limit alcohol consumption, and maintain good daily habits.