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Information Journal Paper

Title

DIAGNOSIS OF HYPOKALEMIA A PROBLEM-SOLVING APPROACH TO CLINICAL CASES

Pages

  115-122

Abstract

 In situations where the cause of HYPOKALEMIA is not obvious, measurement of urinary potassium excretion and blood pressure and assessment of acid-base balance are often helpful. A random urine potassium-creatinine ratio (K/C) less than 1.5 suggests poor intake, gastrointestinal losses, or a shift of potassium into cells. If HYPOKALEMIA is associated with paralysis, we should consider hyperthyroidism, familial or sporadic periodic paralysis. METABOLIC ACIDOSIS with a urine K/C ratio less than 1.5 suggests lower gastrointestinal losses due to diarrhea or laxative abuse. METABOLIC ACIDOSIS with K/C ratio of 1.5 higher is often due to diabetic ketoacidosis or type 1 or type 2 distal renal tubular acidosis. METABOLIC ALKALOSIS with a K/C ratio less than 1.5 and a normal blood pressure is often due to surreptitious vomiting. METABOLIC ALKALOSIS with a higher K/C ratio and a normal blood pressure suggests diuretic use, Bartter syndrome, or Gitelman syndrome. METABOLIC ALKALOSIS with a high urine K/C ratio and HYPERTENSION suggests primary hyperaldosteronism, Cushing syndrome, congenital adrenal hyperplasia, renal artery stenosis, apparent mineralocorticoid excess, or Liddle syndrome. Hypomagnesemia can lead to increased urinary potassium losses and HYPOKALEMIA. The differential rests upon measurement of blood magnesium, aldosterone and rennin levels, diuretic screen in urine, response to spironolactone and amiloride, measurement of plasma cortisol level and the urinary cortisol-cortisone ratio, and genetic testing.

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    • Cite

    APA: Copy

    ASADI, FARAHNAK. (2008). DIAGNOSIS OF HYPOKALEMIA A PROBLEM-SOLVING APPROACH TO CLINICAL CASES. IRANIAN JOURNAL OF KIDNEY DISEASES (IJKD), 2(3), 115-122. SID. https://sid.ir/paper/308653/en

    Vancouver: Copy

    ASADI FARAHNAK. DIAGNOSIS OF HYPOKALEMIA A PROBLEM-SOLVING APPROACH TO CLINICAL CASES. IRANIAN JOURNAL OF KIDNEY DISEASES (IJKD)[Internet]. 2008;2(3):115-122. Available from: https://sid.ir/paper/308653/en

    IEEE: Copy

    FARAHNAK ASADI, “DIAGNOSIS OF HYPOKALEMIA A PROBLEM-SOLVING APPROACH TO CLINICAL CASES,” IRANIAN JOURNAL OF KIDNEY DISEASES (IJKD), vol. 2, no. 3, pp. 115–122, 2008, [Online]. Available: https://sid.ir/paper/308653/en

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