Nephrology Book

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Potassium ReplacementAka: Potassium Supplementation

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  1. See Also
    1. Dietary Potassium
  2. Indications
    1. Hypokalemia
  3. Precautions: Adjust protocol for renal disease
    1. Oliguria: Urine Output < 30 ml/hour
    2. Renal Failure: Serum Creatinine > 3.0 mg/dl
  4. Management: Oral Potassium Replacement
    1. Dietary Sources: Fruits and Vegetables
      1. See Foods with High Potassium Content
      2. May supply 40-60 meq/day
    2. Oral KCl powder 20 meq in water or juice
      1. Serum Potassium < 3.0
        1. Give KCl 20 meq PO every 2 hours for 4 doses
      2. Serum Potassium: 3.0 to 3.5
        1. Give KCl 20 meq PO every 2 hours for 2 doses
  5. Management: IV Potassium Replacement
    1. IV Preparations
      1. Potassium Chloride (KCl) 10 meq IV "bump"
    2. IV Replacement Algorithm
      1. Use 10 meq KCl IV in 50ml D5W over 30 minutes minimum
        1. In select situations, may give up to 40 meq in 1 hr
        2. Example indication for faster delivery: DKA
        3. Cardiac monitoring and recheck Serum Potassium
      2. Serum Potassium < 3.0
        1. Give KCl 10 meq IV slowly every hour for 5 doses
      3. Serum Potassium: 3.0 to 3.5
        1. Give KCl 10 meq IV slowly every hour for 3 doses

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