Which department to go to for hypokalemia?

Written by Wei Shi Liang
Intensive Care Unit
Updated on September 20, 2024
00:00
00:00

Hypokalemia is defined as having a blood potassium level below 3.5 mmol/L. In hospitals, when treating mild hypokalemia, it is essential to identify and treat the primary disease in the corresponding department, such as endocrinology, internal medicine, or gastroenterology. Additionally, timely oral potassium supplementation is necessary to correct the hypokalemia. If severe hypokalemia occurs clinically, with blood potassium levels less than 2.5 mmol/L, treatment in the intensive care unit is required. It is crucial to establish an intravenous access for potassium supplementation immediately. The rate of potassium supplementation should be slow, and blood potassium levels must be monitored continuously.

Other Voices

doctor image
home-news-image
Written by Li Fang Fang
Hematology
48sec home-news-image

Hypokalemia is a condition.

Hypokalemia is classified as an electrolyte disorder. When suffering from hypokalemia, patients may experience general weakness and poor appetite. In severe cases, paralysis of the limbs may occur. There are certain causes of hypokalemia, which can be divided into three types. One is reduced intake, the second is excessive loss, and the third is abnormal distribution. Reduced intake mainly refers to patients with poor diets; excessive loss is common in patients with infections, diarrhea, and those who excrete a high amount of potassium in their urine; abnormal distribution refers to potassium moving from the extracellular space into cells, causing hypokalemia.

doctor image
home-news-image
Written by Wei Shi Liang
Intensive Care Unit
1min 4sec home-news-image

Causes of hypokalemia

Potassium is one of the essential electrolytes necessary for life. Its physiological functions mainly include maintaining cellular metabolism, regulating osmotic pressure and acid-base balance, and preserving cell stress response, etc. Daily potassium intake is about 100 millimoles, with 90% excreted through the kidneys and the remainder through the gastrointestinal tract. Common causes of hypokalemia include reduced intake, such as long-term inability to eat without timely potassium supplementation. Even though potassium intake decreases, the kidneys continue to excrete potassium, leading to potassium loss. The second cause is increased excretion, which includes losses through the gastrointestinal tract and the kidneys, both of which can lead to hypokalemia. The third cause is the movement of potassium from outside to inside the cells, which can occur during metabolic alkalosis or when glucose and insulin are administered, promoting the transfer of potassium ions into the cells, resulting in hypokalemia.

doctor image
home-news-image
Written by Wei Shi Liang
Intensive Care Unit
1min 1sec home-news-image

Clinical manifestations of hypokalemia

The clinical manifestations of hypokalemia are diverse, with the most life-threatening symptoms affecting the cardiac conduction system and the neuromuscular system. Mild hypokalemia on an electrocardiogram presents as flattened T waves and the appearance of U waves, while severe hypokalemia can lead to fatal arrhythmias such as ventricular tachycardia and ventricular fibrillation. In the neuromuscular system, the most prominent symptoms of hypokalemia are skeletal muscle flaccid paralysis and sustained smooth muscle tension, which can involve the respiratory muscles and lead to respiratory failure. Hypokalemia can also cause insulin resistance or hinder insulin release, leading to significant glucose tolerance abnormalities. Reduced potassium excretion decreases the kidney's ability to concentrate urine, resulting in polyuria and urine with low specific gravity.

doctor image
home-news-image
Written by Wei Shi Liang
Intensive Care Unit
46sec home-news-image

The impact of hypokalemia on skeletal muscle

In clinical practice, hypokalemia can affect the muscular and nervous conduction systems. The most prominent symptoms of hypokalemia in the neuromuscular system are flaccid paralysis of the skeletal muscles, loss of tension in smooth muscles, and rhabdomyolysis. If the respiratory muscles are involved, it can lead to respiratory failure. Hypokalemia can also lead to insulin resistance, resulting in significantly abnormal glucose tolerance. If hypokalemia occurs clinically, it is crucial to actively treat the primary disease, appropriately supplement potassium, monitor during the supplementation process to avoid hyperkalemia, and closely monitor blood potassium levels with regular reviews.

doctor image
home-news-image
Written by Wang Li Bing
Intensive Care Medicine Department
44sec home-news-image

How to treat hypokalemia?

After the occurrence of hypokalemia, there are generally two methods of potassium supplementation clinically. The first is oral potassium supplementation, which is relatively safe, and one can also eat fruits or vegetables rich in potassium. The second method is intravenous potassium supplementation. The first thing to note with intravenous supplementation is the patient's urination status. If the patient’s urination is normal, potassium chloride can be administered intravenously but must be diluted. In clinical practice, the concentration of intravenous potassium chloride generally does not exceed 0.3%, so we must pay attention to the concentration during potassium supplementation.