Hypokalemia is formed in what way?

Written by Chen Xie
Endocrinology
Updated on November 24, 2024
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Hypokalemia refers to a condition where the serum potassium level is below 3.5 millimoles per liter. The primary cause of hypokalemia is the loss of potassium in the body. Hypokalemia can be classified into three types based on its cause: potassium deficiency hypokalemia, redistributive hypokalemia, and dilutional hypokalemia. Potassium deficiency hypokalemia is mainly characterized by insufficient intake or excessive excretion. Insufficient intake is typically seen in patients who are fasting, have selective eating habits, or suffer from anorexia, while excessive excretion is mainly through gastrointestinal or renal loss of potassium. Redistributive hypokalemia usually occurs due to metabolic or respiratory alkalosis, the recovery phase of acidosis, heavy usage of glucose, instances of periodic paralysis, acute emergency situations, and the use of folic acid and vitamin B12 in treating anemia or repeat transfusions of cold stored washed red blood cells. Dilutional hypokalemia, on the other hand, is mainly caused by the retention of extracellular fluid, leading to excessive water or water intoxication-induced hypokalemia.

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Early electrocardiogram manifestations of hypokalemia

When hypokalemia occurs in the human body, it produces characteristic manifestations on the electrocardiogram (ECG) known as U waves. These so-called U waves appear as small waves at the tail end of the ST-T segment, often accompanied by a slight depression of the ST-T segment and mild changes in the T wave. If hypokalemia is severe, it can induce supraventricular arrhythmias, including premature ventricular contractions or first-degree atrioventricular block. In very severe cases, it may lead to life-threatening torsades de pointes, a type of ventricular tachycardia. Therefore, monitoring blood potassium levels and timely potassium supplementation are crucial for these patients to protect their health and safety.

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Written by Gan Jun
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Patients with hypokalemia can have what kind of urine?

When patients have hypokalemia, they often exhibit paradoxical aciduria, which is a typical manifestation of hypokalemia. In hyperkalemia, however, there is paradoxical alkaline urine. When serum potassium ions decrease, the renal tubular epithelium reduces its potassium excretion function and instead increases hydrogen excretion, leading to increased reabsorption of sodium and bicarbonate. This results in metabolic alkalosis, causing an increase in plasma bicarbonate, unlike typical alkalosis where alkaline urine is excreted. However, in the case of hypokalemia, acidic urine is excreted, hence it is called paradoxical aciduria.

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Written by Gan Jun
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What are the symptoms of hypokalemia?

When the body's blood potassium level falls below 3.5 millimoles per liter, it is called hypokalemia. Hypokalemia can cause adverse symptoms in multiple systems of the body, initially causing weakness and fatigue in the limbs, flaccid paralysis, sluggish and absent tendon reflexes, and in severe cases, respiratory difficulty. At the same time, hypokalemia can lead to a series of central nervous system damages, such as apathy, a blank stare, drowsiness, and confusion; it also causes nausea, poor appetite, abdominal distension, and intestinal paralysis among other adverse gastrointestinal phenomena. Additionally, it can lead to palpitations, and rapid atrial or ventricular arrhythmias, among other adverse phenomena. Therefore, it is crucial to provide timely and proper potassium supplementation and correction of blood potassium levels for patients with hypokalemia.

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Written by Wei Shi Liang
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How many days does hypokalemia need to be treated?

In the extracellular fluid of human cells, the concentration of potassium in the blood is 3.5 to 5.5 millimoles per liter. If the potassium level falls below 3.5 millimoles per liter, it is considered hypokalemia. The main causes of hypokalemia are insufficient intake and excessive excretion. The treatment duration for hypokalemia caused by different primary diseases varies. For mild hypokalemia, oral potassium supplements alone can correct the condition, but this generally takes about three to five days. For severe hypokalemia, intravenous potassium should be administered as soon as possible, preferably through a central venous line for fluid administration. At this time, the focus is on treating the underlying disease and timely supplementation of potassium ions. The duration of treatment may be relatively longer, and it is not possible to determine a specific timeframe.

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Can people with hypokalemia smoke?

Hypokalemia is not directly related to smoking. However, once hypokalemia occurs, there is definitely an underlying disease. In the case that the primary disease is not controlled, it is advisable to avoid smoking. Potassium is an essential electrolyte for life, and its physiological functions mainly include maintaining cellular metabolism, regulating osmotic pressure, acid-base balance, and maintaining cell stress functions. Once hypokalemia occurs, active treatment should be implemented, primarily addressing the primary disease, symptomatic treatment with potassium supplementation, and avoiding the occurrence of hyperkalemia. The principle of potassium supplementation is that for mild hypokalemia without clinical manifestations, oral potassium should be given; in cases of severe hypokalemia, intravenous potassium supplementation should be administered immediately. Intravenous potassium should ideally not use peripheral veins but establish a central vein, and the speed of potassium supplementation and the monitoring of potassium levels should be controlled.