Symptoms, causes and treatment of hypokalemia

The article was written by Doctor Nguyen Ngoc Phuong Nam - Emergency Medicine Doctor - Emergency Department - Vinmec Central Park International General Hospital.

Hypokalemia is the term used to describe a condition in which the blood potassium level is lower than normal. Normally, blood potassium levels are 3.6-5.2 millimoles per liter of blood (mmol/l). Very low blood potassium levels (less than 2.5 mmol/l) can be life-threatening and require immediate medical attention.

Mild to moderate hypokalemia often has no clinical manifestations. Symptoms usually manifest when blood potassium drops below 3.0 mmol/L: Muscle weakness, constipation, cramps, respiratory muscle weakness ECG changes such as ST changes, flattened T waves, U waves, ... Changes Heart rate: Sinus tachycardia, ventricular tachycardia, ventricular fibrillation, digoxin poisoning, ... Rhabdomyolysis, or muscle paralysis.

Hypokalemia may be the result of a lack of dietary potassium or increased loss of potassium, disturbances in the distribution of potassium in and out of cells. Lack of potassium supply such as alcoholism, loss of appetite. Increased loss of potassium: + Gastrointestinal diseases: Vomiting, diarrhea, abdominal drainage...
+ Loss of potassium through the kidneys or dialysis. Magnesium deficiency.
+ Drug use: Diuretics (thiazides, Loop diuretics), glucocorticoids, fludrocortisone, penicillins, amphotericin, aminoglycosides
+ Endocrine disorders: Increased aldosterone (Cushing's syndrome, Conn's syndrome)
Disturbance in distribution in and Extracellular: Treatment of salbutamol, theophylline, beta-blockers, insulin + glucose, metabolic alkalosis

Goal: Prevent or treat life-threatening complications (arrhythmias, paralysis, rhabdomyolysis, and diaphragmatic weakness) by replacing potassium. Diagnose and fix the underlying cause. The urgency of treatment depends on the severity of the hypokalemia, the associated conditions and/or coma, and the rate at which serum potassium levels decrease. With asymptomatic hypokalemia, potassium replacement is usually given orally. With severe hypokalemia, threatening arrhythmias, or symptoms, intravenous potassium replacement is required. Find and correct the underlying cause, acute causes such as dehydration diarrhea, loss of potassium, when the diarrhea stops, the cause of hypokalemia will no longer exist. But chronic causes such as alcoholism, potassium-losing diuretics....should be controlled and monitored periodically. If you need to consult and visit the hospitals and clinics of Vinmec Health system nationwide, please contact the Website for the best service.