Nephrology Book

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Hypokalemia

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  1. Pathophysiology
    1. Approximate Total body potassium = 55 meq/kg
    2. Serum Potassium decreased 1 meq/dl: 350 meq K+ deficit
    3. Serum Potassium less than 2 meq/dl: 1000 meq K+ deficit
  2. Symptoms and Signs (when Serum Potassium < 2.5)
    1. General
      1. Malaise
      2. Fatigue
    2. Neurologic
      1. Weakness
      2. Decreased Deep Tendon Reflexes
      3. Paresthesia
      4. Cramps
      5. Restless legs Syndrome
      6. Rhabdomyolysis
      7. Paralysis
    3. Gastrointestinal
      1. Constipation
      2. Ileus
      3. Exacerbated Hepatic Encephalopathy
    4. Cardiovascular
      1. Orthostatic Hypotension
      2. Hypertension
      3. Arrhythmias (especially with Digoxin use)
    5. Renal
      1. Metabolic Alkalosis
      2. Polyuria, Polydipsia
      3. Decreased GFR
      4. Glucose Intolerance
  3. Labs
    1. Electrocardiogram
      1. T Waves flattened
      2. Prominent U Waves
      3. ST depression
  4. Diagnosis
    1. Exclude Transcellular Potassium Shift
    2. Check 24 hour Urine Potassium and Urine Sodium
      1. Sample should have total Urine Sodium > 100 meq
    3. Interpretation
      1. Urine Potassium <20 meq/day
        1. Extrarenal Potassium Loss
      2. Urine Potassium >20 meq/day
        1. Renal Potassium Loss
  5. Management
    1. See Potassium Replacement

Hypokalemia (C0020621)

Definition (MSH)Abnormally low potassium concentration in the blood. It may result from potassium loss by renal secretion or by the gastrointestinal route, as by vomiting or diarrhea. It may be manifested clinically by neuromuscular disorders ranging from weakness to paralysis, by electrocardiographic abnormalities (depression of the T wave and elevation of the U wave), by renal disease, and by gastrointestinal disorders. (Dorland, 27th ed)
Definition (CSP)abnormally low potassium concentration in the blood; may result from excessive potassium loss by the renal or gastrointestinal route, from decreased intake, or from transcellular shifts; manifested clinically by neuromuscular disorders ranging from weakness to paralysis, by electrocardiographic abnormalities, and by renal and gastrointestinal disorders.
Definition (NCI)Hypokalemia; lower than normal levels of potassium in the circulating blood.
ConceptsFinding (T033)
ICD9276.8, 276.8
MSHD007008
EnglishHYPOKALAEMIA, Hypokalaemic syndrome, Hypokalemia, Hypokalemias, Hypokalemic syndrome, Hypopotassaemia, Hypopotassaemia syndrome, Hypopotassemia, Hypopotassemia syndrome, Hypopotassemias, K deficiency, LOW POTASSIUM SYNDROME, Potassium deficiency, Potassium depletion, SYNDROME HYPOKALEMIC
Spanishdeficiencia de K, deplecion de potasio, hipocalemia, hipocaliemia, hipokalemia, hipopotasemia, sindrome hipocalemico, sindrome hipopotasemico
Parent ConceptsDisorder of fluid AND/OR electrolyte (C0267994), Electrolyte Balance (C0013831), Potassium disorder (C0268014), POTASSIUM ABNORMALITY (C0549635), Water-Electrolyte Imbalance (C0043065), Abnormal Blood Chemistry and Hematology Test Result (C1332129), Duplicate concept (C1274013)
SourcesAOD, CCS, COSTAR, CSP, CST, DXP, ICD9CM, LCH, MSH, MTH, MTHICD9, NCI, NDFRT, OMIM, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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