Common Causes
Hypokalemia (low potassium) has many of the same symptoms of hyperkalemia, including numbness and tingling, heart palpitations, and shortness of breath. Arguably, the biggest difference is the development of muscle cramps and twitches, which is more common with hypokalemia.
Related Conditions
Your risks for hypokalemia can increase if you:
- take medications, especially diuretics known to cause potassium loss
- have prolonged illness that causes vomiting or diarrhea
- have a medical condition like the ones listed above
What are the signs and symptoms of hypokalemia?
Possible causes of hyperkalemia may include: Chronic kidney disease: A lower kidney capacity means that the kidneys may not be able to filter potassium out of the body adequately. Uncontrolled or untreated diabetes: As a decrease in kidney function is a possible complication of diabetes, poorly managing the condition may result in hyperkalemia.
Which condition may cause hypokalemia?
The most common causes include:
- Kidney Disease. Hyperkalemia can happen if your kidneys do not work well. ...
- A diet high in potassium. Eating too much food that is high in potassium can also cause hyperkalemia, especially in people with advanced kidney disease. ...
- Drugs that prevent the kidneys from losing enough potassium. Some drugs can keep your kidneys from removing enough potassium. ...
What condition may result in hyperkalemia?
What are the causes of hyperkalemia?
See more
What are some manifestations of hypokalemia?
More severe cases of low potassium may cause signs and symptoms such as: Muscle twitches. Muscle cramps. Severe muscle weakness, leading to paralysis....What are the symptoms of hypokalemia?Constipation.Heart palpitations.Extreme tiredness (fatigue).Muscle weakness and spasms.Tingling and numbness.
Which clinical manifestations will typically be found upon assessment of an individual with hypokalemia?
The symptoms of hypokalemia are nonspecific and predominantly are related to muscular or cardiac function. Weakness and fatigue are the most common complaints. The muscular weakness that occurs with hypokalemia can manifest in protean ways (eg, dyspnea, constipation or abdominal distention, exercise intolerance).
What are 3 causes of hypokalemia?
Causes of potassium loss include:Alcohol use (excessive)Chronic kidney disease.Diabetic ketoacidosis.Diarrhea.Diuretics (water retention relievers)Excessive laxative use.Excessive sweating.Folic acid deficiency.More items...
How do you identify hypokalemia?
Once your potassium levels fall below a certain level, you might experience:Weakness.Fatigue.Muscle cramps or twitching.Constipation.Arrhythmia (abnormal heart rhythms)
What is a common manifestation of hyperkalemia?
If hyperkalemia comes on suddenly and you have very high levels of potassium, you may feel heart palpitations, shortness of breath, chest pain, nausea, or vomiting.
Which clinical manifestation is common to both hypokalemia and hyperkalemia?
Clinical Manifestations of Hyperkalemia Severe hyperkalemia, like severe hypokalemia, can cause skeletal muscle weakness, even to the point of paralysis and respiratory failure.
What medications can cause hypokalemia?
Drugs that can cause hypokalemia include the following: Diuretics (carbonic anhydrase inhibitors, loop diuretics, thiazide diuretics): Increased collecting duct permeability or increased gradient for potassium secretion can result in losses. Methylxanthines (theophylline, aminophylline, caffeine)
Who is most at risk for hypokalemia?
Overview. Risk factors associated with a low serum potassium levels (hypokalemia) include female gender, intake of medication (diuretics), heart failure, hypertension, low body mass index (BMI), eating disorder, alcoholism, diarrhea, Cushing's syndrome.
What medications can cause low potassium?
Medications that can cause low potassium levelsDiuretics. Diuretics, or water pills, help treat medical conditions like high blood pressure and heart failure. ... Short- and long-acting beta agonists. ... Laxatives. ... Aminoglycosides. ... Amphotericin B. ... Insulin. ... Angiotensin-converting enzyme inhibitors. ... Angiotensin II receptor blockers.More items...•
What are the signs of hypokalemia potassium?
Common signs and symptoms of potassium deficiency include weakness and fatigue, muscle cramps, muscle aches and stiffness, tingles and numbness, heart palpitations, breathing difficulties, digestive symptoms, and changes in blood pressure.
What should you monitor for hypokalemia?
If your potassium levels are too low (hypokalemia), your symptoms may include: Irregular heartbeat. Muscle cramps. Weak or twitching muscles....Why do I need a potassium blood test?Arrhythmia (a problem with the rate or rhythm of your heartbeat)Fatigue.Muscle weakness.Nausea.Numbness or tingling.
How do you treat hypokalemia?
Decreasing Potassium LossesDiscontinue diuretics/laxatives.Use potassium-sparing diuretics if diuretic therapy is required (eg, severe heart failure)Treat diarrhea or vomiting.Administer H2 blockers to patients receiving nasogastric suction.Control hyperglycemia if glycosuria is present.
What are signs of medical emergency when the patient is Hypokalemic?
Symptoms of severe hypokalemia include muscle weakness, muscle pain, cramps, rhabdomyolysis, and constipation. It has been reported that 49% of patients with severe hypokalemia had symptoms, with the most common symptom being weakness, which was reported in 73% of patients.
What are the cardiovascular manifestations of hypokalemia?
Hypokalemia is associated with increased risk of arrhythmia in patients with cardiovascular disease, as well as increased all-cause mortality, cardiovascular mortality and heart failure mortality by up to 10-fold.
What is the nurse closely assessing for in a patient with hypokalemia?
The nurse closely assesses a patient with hypokalemia for: cardiac complications.
What arrhythmias are caused by hypokalemia?
Clinically, hypokalemia is associated with triggered arrhythmias such as Torsades De Pointes (TDP), polymorphic VT, ventricular fibrillation (VF), and ventricular ectopy (Nordrehaug et al., 1985).
Why is my potassium low?
Causes. There are many different reasons you could have low potassium levels. It may be because too much potassium is leaving through your digestive tract. It’s usually a symptom of another problem. Most commonly, you get hypokalemia when: You vomit a lot. You have diarrhea.
What does it mean when you have hypokalemia?
In this Article. If you have hypokalemia, that means you have low levels of potassium in your blood. Potassium is a mineral your body needs to work normally. It helps muscles to move, cells to get the nutrients they need, and nerves to send their signals. It’s especially important for cells in your heart.
How to get more potassium?
You can get more potassium by taking supplements. Most of these you can take by mouth. In some cases it’s necessary to get your potassium injected by IV. For example:
Can taking potassium supplements cause hypokalemia?
If taking supplements don’t raise your potassium levels. If your low potassium levels cause abnormal heart rhythms. When your hypokalemia is a result of another medical condition, your doctor will help you treat that. If you have low potassium because of diuretics, they may take you off them.
Can hypokalemia cause thirst?
Hypokalemia can affect your kidneys. You may have to go to the bathroom more often. You may also feel thirsty.
Can too little potassium cause hypokalemia?
It’s possible , but rare, to get hypokalemia from having too little potassium in your diet. Other things sometimes cause it, too, like:
Do women get hypokalemia more often than men?
Women tend to get hypokalemia more often than men.
What does having low potassium levels in your blood mean?
Low potassium levels in your blood is also called hypokalemia. Normal levels of potassium range from 3.5 mmol/L to 5.1 mmol/L in adults. (Reference ranges are not the exact same at every laboratory). Usually, levels under 2.5 mmol/L are considered to be very serious.
What does potassium do for your body?
Potassium levels are very important in keeping your muscles, nerves, and heart working well. Potassium, an electrolyte, is also important for digestive health and for bone health.
What is the treatment for low potassium levels?
Potassium supplements are generally prescribed for low potassium levels. If the situation is severe, potassium might be given as an intravenous (IV) solution. If there is a condition that causes the hypokalemia, such as low levels of magnesium or an overactive thyroid, the other condition must be treated also.
What foods provide potassium?
The following is a list of some, but not all, foods that provide potassium:
What are the symptoms of low potassium?
Mild cases of low potassium might not cause symptoms. More severe cases might cause: 1 Muscle twitches 2 Muscle cramps or weakness 3 Muscles that will not move (paralysis) 4 Abnormal heart rhythms 5 Kidney problems
Is potassium below 2.5 mmol/L dangerous?
Potassium levels below 2.5 mmol/L are considered to be serious. Low levels have many causes. Supplements and foods can provide potassium. Appointments & Access. Contact Us. Overview. Symptoms and Causes. Diagnosis and Tests. Management and Treatment.
When is potassium replacement indicated?
Potassium replacement is primarily indicated when hypokalemia is due to potassium loss, and there is a significant deficit in body potassium. It is also warranted for acute therapy in disorders such as hypokalemic or thyrotoxic periodic paralysis in which the hypokalemia is due to redistribution of potassium into the cells, often in association with significant symptoms. Potassium is given cautiously in redistributive hypokalemia since the hypokalemia is transient and the administration of potassium can lead to rebound hyperkalemia when the underlying process is corrected and potassium moves back out of the cells. The recommended regimens for acute therapy in this disorder are presented elsewhere. (See "Hypokalemic periodic paralysis", section on 'Acute treatment' and "Thyrotoxic periodic paralysis", section on 'Acute treatment' .)
What is the severity of hypokalemia?
The severity of the manifestations of hypokalemia tends to be proportionate to the degree and duration of the reduction in serum potassium. Symptoms generally do not become manifest until the serum potassium is below 3.0 mEq/L, unless the serum potassium falls rapidly or the patient has a potentiating factor, such as a predisposition ...
Can potassium cause hypokalemia?
Although hypokalemia can be transiently induced by the entry of potassium into the cells, most cases result from unreplenished gastrointestinal or urinary losses due, for example, to vomiting, diarrhea, or diuretic therapy [ 1-3 ]. (See "Causes of hypokalemia in adults" .)
Is potassium given in redistributive hypokalemia?
Potassium is given cautiously in redistributive hypokalemia since the hypokalemia is transient and the administration of potassium can lead to rebound hyperkalemia when the underlying process is corrected and potassium moves back out of the cells.
Is UpToDate a substitute for medical advice?
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of UpToDate content is governed by the UpToDate Terms of Use. ©2021 UpToDate, Inc. All rights reserved.
Who endorses the practice standards for electrocardiographic monitoring in hospital settings?
Practice standards for electrocardiographic monitoring in hospital settings: an American Heart Association scientific statement from the Councils on Cardiovascular Nursing, Clinical Cardiology, and Cardiovascular Disease in the Young: endorsed by the International Society of Computerized Electrocardiology and the American Association of Critical-Care Nurses. Circulation 2004; 110:2721.
What causes hypokalemia in the kidneys?
Hypokalemia can be caused either by decreased intake of potassium or by excessive losses of potassium in the urine or through the GI tract (17, 18). The latter is more common. Excessive excretion of potassium in the urine (kaliuresis) may result from the use of diuretic drugs, endocrine diseases such as primary hyperaldosteronism, kidney disorders and genetic syndromes affecting the renal function (19). Gastrointestinal losses of potassium usually are due to prolonged diarrhea or vomiting, chronic laxative abuse, intestinal obstruction or infections. An intracellular shift of the potassium can also lead to severe hypokalemia. Insulin administration, stimulation of the sympathetic nervous system, thyreotoxicosis and familiar periodic paralysis are some of the reasons for this phenomenon (20). Congenital adrenal hyperplasia due to enzymatic defects is a genetic syndrome strongly associated with hypertension and hypokalemia, resulting from excessive mineralocorticoid effects. Drugs, such as diuretics and penicillin can be often the underlying cause of hypokalemia. Finally, hypomagnesemia is very important. More than 50% of clinically significant hypokalemia has concomitant magnesium deficiency and is clinically most frequently observed in individuals receiving loop or thiazide diuretic therapy. Concomitant magnesium deficiency has long been appreciated to aggravate hypokalemia. Hypokalemia associated with magnesium deficiency is often refractory to treatment with K+(21) (Table 1).
How to identify publications on hypokalemia?
In order to identify publications on hypokalemia, a literature search was conducted in PubMed using combinations of the key-terms: ‘potassium’ OR ‘hypokalemia’ OR ‘hypokalaemia’ OR ‘electrolyte disturbances’ AND ‘guide’ OR ‘algorithm’ OR ‘guidelines’. In addition, a manual search of key journals and abstracts from the major annual meetings in the fields of endocrinology and nephrology was conducted. This review collected, analyzed and qualitatively re-synthesized information regarding: (1) the definition and prevalence of hypokalemia, (2) the physiology of potassium homeostasis, (3) the various causes leading to hypokalemia, (4) the diagnostic steps for the assessment of hypokalemia and (5) the appropriate treatment of hypokalemia depending on the cause.
What are the two determinants of K+secretion?
Two principal determinants of K+secretion are mineralocorticoid activity and distal delivery of Na+and water. Aldosterone is the major mineralocorticoid in humans and mediates the renal excretion of K+and Na+reabsorption by binding to the mineralocorticoid receptors in the distal tubules and collecting ducts of the nephron. Aldosterone increases intracellular K+concentration by stimulating the activity of the Na+-K+-ATPase in the basolateral membrane, stimulates Na+reabsorption across the luminal membrane, which increases the electronegativity of the lumen, thereby increasing the electrical gradient favoring K+secretion and lastly has a direct effect on the luminal membrane to increase K+permeability (10). Under conditions of volume depletion, activation of the renin-angiotensin system leads to increased aldosterone release. The increase in circulating aldosterone stimulates renal Na+retention, contributing to the restoration of ECF volume, but occurs without a demonstrable effect on renal K+secretion. When hyperkalemia occurs, aldosterone release is mediated by a direct effect of K+on cells in the zona glomerulosa. The subsequent increase in circulating aldosterone stimulates renal K+secretion, restoring the serum K+concentration to normal, but does so without concomitant renal Na+retention. The ability of aldosterone to signal the kidney to stimulate salt retention without K+secretion in volume depletion and stimulate K+secretion without salt retention in hyperkalemia has been referred to as the aldosterone paradox (11).
What are the effects of hypokalemia on the renal system?
The effects of hypokalemia regarding the renal function can be metabolic acidosis, rhabdomyolysis (in severe hypokalemia) and , rarely, impairment of tubular transport, chronic tubulointerstitial disease and cyst formation.
What is hypokalemia in the body?
Hypokalemia is present when serum levels of potassium are lower than normal. It is a rather common electrolyte disturbance, especially in hospitalized patients, with various causes and sometimes requires urgent medical attention (1). It usually results from increased potassium excretion or intracellular shift and less commonly from reduced ...
What is hypokalemia in medical terms?
Hypokalemia is a common electrolyte disturbance, especially in hospitalized patients. It can have various causes, including endocrine ones. Sometimes, hypokalemia requires urgent medical attention. The aim of this review is to present updated information regarding: (1) the definition and prevalence of hypokalemia, ...
How does intracellular potassium affect acid-base regulation?
Of great importance, intracellular K+parti cipates in acid–base regulation through exchange for extracellular hydrogen ions (H+) and by influencing the rate of renal ammonium production (4). Counterregulatory mechanisms exist in order to defend against potassium alterations. These mechanisms serve to maintain a proper distribution of K+within the body, as well as to regulate the total body K+content. Excessive ECF potassium (hyperkalemia) decreases membrane potential, while hypokalemia causes hyperpolarization and non-responsiveness of the membrane (5). If potassium balance is disrupted (hypokalemia or hyperkalemia), this can also lead to disruption of heart electrical conduction, dysrhythmias and even sudden death. Potassium balance has a direct negative effect on (H+) balance at intracellular and extracellular level and the overall cellular activity.
What is hypokalemia?
Hypokalemia is a low level of potassium in your blood. Potassium helps control how your muscles, heart, and digestive system work. Hypokalemia occurs when your body loses too much potassium or does not absorb enough from food.
How is hypokalemia diagnosed?
An EKG test records your heart rhythm and how fast your heart beats. It is used to check for an irregular heartbeat.
What foods are high in potassium?
Foods that are high in potassium include bananas, oranges, tomatoes, potatoes, and avocado. Pinto beans, turkey, salmon, lean beef, yogurt, and milk are also high in potassium. Ask your healthcare provider or dietitian for more information about foods that are high in potassium.
How do you know if you have hypokalemia?
You may have any of the following if it is more severe: Fatigue. Constipation. Frequent urination or urinating large amounts. Muscle cramps or skin tingling. Muscle weakness. Fast or irregular heartbeat.
Can you refuse treatment?
You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.
What causes cramps and spasms in the body?
The uncontrolled contractions of your muscles are spasms or cramps, and they can be very painful. Low levels of potassium in the blood trigger these spasms more frequently.
Why does potassium cause numbness?
The presence of persistent tingling sensations and numbness (paresthesia) is a sign of potassium deficiency. Because potassium plays an important role in nerve function, a deficiency can disrupt nerve communication and weaken signals.
What happens when potassium is low?
As a key player in nerve signaling, when potassium is low, signals in your brain are disrupted, impacting brain function. While there are numerous causes to mood disturbances and disorders, potassium may be the cause. You should consult your doctor should you notice anything unusual.
How to increase potassium levels?
How to Increase Your Potassium Levels. To correct a potassium deficiency, all you need to do is increase your dietary intake. The best potassium-rich foods to try include yams, bananas, clams, white beans, avocado, chicken, kiwis, oranges, pinto beans, and sweet potatoes.
Why do my muscles ache?
Your muscles can become stiff and continuously ache, which is caused by rapid muscle breakdown. Severely low levels of potassium in your blood restrict blood flow to your muscles. Your muscle cells become starved of oxygen and they can leak or rupture, which results in full muscle breakdown and stiffness. 4.
What happens if you don't have enough potassium?
Without adequate potassium, your lung muscles are not able to efficiently expand and contract, so you end up with shortness of breath or labored breathing. Low potassium also affects breathing when it changes your heartbeat.
What happens when you lose too much fluid?
More commonly, hypokalemia occurs when your body loses too much fluid. This can occur as a result of chronic vomiting, diarrhea, blood loss, or excessive sweating. In most cases people are not aware of the deficiency, so it remains untreated.
