Carl R. Darnall Army Medical Center - Health Library

Hypokalemia

Definition

Potassium is a mineral that is needed to help the heart, kidneys, and other organs function. Hypokalemia is lower than normal levels of potassium in your blood.

All cells within the body need potassium. It works to regulate water and mineral balance throughout the body. Low levels can cause muscle and nerve problems throughout the body. It can also cause an irregular heart rate.

Causes  ^

Potassium enters the body through food and digestion. It passes out of the blood through the kidneys. Hypokalemia occurs when there is not enough potassium being absorbed into the body, too much potassium is removed by the kidneys, or potassium moves from the blood into the cells.

Risk Factors  ^

Factors that may increase potassium excretion through the kidneys:

  • Certain medications such as diuretics or beta-2-adrenergic agonists
  • Kidney disease or failure—too much potassium excreted
  • Significant elevation of glucose from poorly controlled diabetes

Factors that may shift potassium into cells:

  • Treatment of elevated glucose and ketoacidosis from poorly controlled diabetes
  • Rapid refeeding after starvation
  • Delirium tremens from severe alcohol withdrawal
  • Excess loss of potassium from diarrhea or sweating

Kidney Damage

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Factors that may decrease the intake or absorption of potassium:

  • Poor diet
  • Eating disorders
  • Excess alcohol intake
  • Vomiting or diarrhea

Symptoms  ^

Early hypokalemia may not have any symptoms. When symptoms do occur, they may include:

  • Fatigue
  • Muscle weakness
  • Constipation
  • Difficulty breathing
  • Tingling or numbness
  • Irregular heartbeat
  • Fainting

Diagnosis  ^

You will be asked about your symptoms and medical history. A physical exam will be done.

Testing may include:

  • Blood tests
  • Urine tests
  • ECG to test the electrical activity of the heart

Treatment  ^

The main goal of treatment is to increase the level of potassium in your body. Talk with your doctor about the best treatment plan for you. Options include:

Medications

IV fluids may be given. You may also be given the following to raise the amount of potassium in your blood if it is very low:

  • Potassium
  • Magnesium

Your current medications may be changed if they are the cause of your hypokalemia.

Any underlying condition will be treated.

Dietary Changes

You may be advised to increase the amount of potassium in your diet. You may be referred to a dietitian to help you balance the potassium in your diet.

Prevention  ^

To help reduce the chances of hypokalemia:

  • Eat a diet that contains enough potassium.
  • Manage conditions such as diabetes.
  • Keep your doctor informed of the medications you are taking and any problems you have taking them correctly.
RESOURCES:

Family Doctor—American Academy of Family Physicians
https://www.familydoctor.org

The American Association of Clinical Endocrinologists
https://www.aace.com

CANADIAN RESOURCES:

Health Canada
https://www.canada.ca

The Canadian Society of Endocrinology and Metabolism
http://www.endo-metab.ca

REFERENCES:

Hypokalemia. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T115951/Hypokalemia. Updated September 17, 2015. Accessed March 26, 2018.

Hypokalaemia. Patient website. Available at: https://patient.info/doctor/hypokalaemia. Updated January 23, 2017. Accessed March 26, 2018.

Hypokalemia. NORD—National Organization for Rare Disorders website. Available at: https://rarediseases.org/rare-diseases/hypokalemia. Accessed March 26, 2018.

Last reviewed March 2018 by EBSCO Medical Review Board Marcin Chwistek, MD  Last Updated: 2/12/2014