HYPOKALEMIA AND HYPERKALEMIA
Section snippets
REGULATION OF INTERNAL POTASSIUM HOMEOSTASIS
A number of factors affect the internal potassium homeostasis; among these factors, acid-base status, plasma insulin concentration, and plasma catecholamine levels are important. Aldosterone activity has a minor role in internal potassium homeostasis.
HYPOKALEMIA
Normal serum potassium ranges from 3.5 to 5.5 mEq/L. Serum potassium less than 3.5 mEq/L is hypokalemia. Common causes of hypokalemia include:
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Diuretics.
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Alcoholism.
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Gastrointestinal disorders (vomiting, gastric suction, diarrhea).
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Renal tubular acidosis type I and II.
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Primary hyperaldosteronism.
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Secondary hyperaldosteronism (renovascular hypertension, renin-secreting tumor).
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Bartter's syndrome.
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Antibiotics, including penicillin, carbenicillin, aminoglycoside, amphotericin.
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Magnesium depletion.
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HYPERKALEMIA
Hyperkalemia is not as common as hypokalemia. If all patients with acute and chronic renal failure are excluded, the incidence of hyperkalemia is rather insignificant. At the outset, it should be stressed that hyperkalemia can be pseudohyperkalemia and is caused most commonly by extravascular hemolysis. Pseudohyperkalemia also can be caused by severe leukocytosis or thrombocytosis. If severe hyperkalemia is observed as an isolated finding in an otherwise normal laboratory report of a patient,
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Address reprint requests to Anil K. Mandal, MD, Department of Medicine (IIIW), VA Medical Center, 4100 West Third Street, Dayton, OH 45428
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From the Section of Nephrology, Department of Veterans Affairs Medical Center; and the Department of Medicine, Wright State University, Dayton, Ohio