Hypokalemia is an electrolyte disturbance in which the amount of potassium in the blood serum is less than 3.8 mmol / l. The ailments that appear when you are deficient in potassium strictly depend on the size of the deficiency of this element. Mild hypokalaemia may be asymptomatic and unobtrusive, while severe hypokalaemia may be life-threatening. What are the causes and symptoms of a potassium deficiency? How is hypokalaemia treated?
Hypokalemiais a disorder resulting from insufficient supply of potassium in the blood serum (below 3.8 mmol / l). Electrolyte tests, like blood count tests, are part of the basic laboratory tests and provide valuable information about the state of our body. Considering the prevalence of hypokalemia, it is worth asking yourself the following questions: What are the causes of hypokalemia? What are its symptoms? How to treat hypokalemia?
Hypokalemia: causes
There are many mechanisms leading to the decreased potassium content in our body:
- The most common cause of hypokalemia is the loss of potassium from the body.
Such a situation may occur as a result of losing water from our body. Increased vomiting, diarrhea as a result of poisoning or infection of the gastrointestinal tract is associated with dehydration and the loss of potassium, sodium and chloride ions. Symptoms may appear after just a few days of these symptoms. Special attention should be given to children who may develop electrolyte disturbances more quickly than adults, and whose symptoms are usually more severe.
- Another cause of hypokalemia is the use of certain drugs that "flush out" potassium from our body.
These include loop diuretics (such as furosemide) and thiazide diuretics. They are used in the treatment of hypertension or in the treatment of edema of various etiologies (congestive heart failure, cirrhosis, renal dysfunction). These substances cause the removal of water from the body along with urine, and this condition favors the loss of macronutrients - especially potassium. Another group of drugs that promote hypokalemia are laxatives. They remove potassium through the digestive tract, and their overdose has been linked todiarrhea and a clinically significant loss of fluid and electrolytes.
Glucocorticosteroids and antibiotics from the aminoglycoside group (gentamicin), commonly used in many respiratory diseases (asthma, pneumonia), also contribute to lowering the level of potassium in the blood. There is also a group of drugs used in the treatment of severe fungal infections (amphotericin) and some neoplasms (cisplatin), which due to its nephrotoxic effect has a negative effect, e.g. just for the potassium level.
The side effect in the form of hypokalemia should also be borne in mind when using Chinese herbs that have recently become popular. It is worth noting here that the use of this type of preparation without proper knowledge and careful study of the composition of a given drug may not only cause electrolyte disturbances but also lead to liver or kidney damage.
The last two groups of drugs, which are very often used by patients, and the action of which, apart from therapeutic, may cause the influx of potassium ions from the extracellular space to the cell and thus lower the level of potassium in the blood are beta mimetics (salbutamol) - used in .in. as first-line drugs in patients with bronchial asthma, and insulin taken subcutaneously by patients in one of the most important civilization diseases of our time, i.e. diabetes.
That is why the phrase "consult a doctor or pharmacist before use" is so important. Appropriate doses of drugs, and not infrequently potassium ion supplementation during therapy, will avoid many undesirable effects.
- A significant group of endocrine disorders is also associated with decreased serum potassium.
Here we can include, among others primary hyperaldosteronism (Conn's syndrome), the most common cause of which is adrenal adenoma, and less frequently their hyperplasia. Aldosterone is a hormone that is produced in the adrenal glands. It is responsible for the secondary reabsorption of sodium ions in the kidneys and the excretion of potassium ions. When this hormone is produced outside the adrenal glands, it is called secondary aldosteronism. This condition can be associated with, for example, cancer: ovarian cancer or kidney cancer are examples of this.
A malignant neoplasm called VIP-ooma, which belongs to rare neurendocrine tumors, secretes significant amounts of vasoactive intestinal peptide causing profuse diarrhea, which can reach a volume of several liters a day! Symptoms will include not only extreme dehydration, hypokalemia, but also metabolic acidosis and arrhythmias, which is not the complete list of cases that may cause hypokalemia. Narrowingrenal artery or Bartter's syndrome are pathological conditions that also manifest themselves, among others, with hypokalemia.
See: Potassium Deficiency Symptoms
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Is Cola harmful?
A 2009 study by the University of Ioannina, Greece, found that chronic consumption of large amounts of Cola (2-3 liters per day) can cause hypokalemia and, in the long term, even associated myopathy. In addition to caffeine, the glucose and fructose contained in this tasty drink induce the loss of potassium from our body. If you are interested, please visit the link at the end of the article. In addition to the loss of potassium, we can also deal with its insufficient supply. Diseases such as anorexia or protein and energy malnutrition, in addition to many dramatic devastating effects, also have a direct impact on the electrolyte balance - including that of potassium ions.
Hypokalemia: symptoms
The symptoms of hypokalemia depend on the degree of deficiency of this element. The most general symptoms are muscle weakness, polyuria, and increased thirst. Many of these symptoms are due to paralysis of smooth muscles due to decreased neuromuscular excitability. For example, paralysis of the bladder muscles will lead to urine retention, and the muscles of the intestine will cause constipation, leading to vomiting or nausea.
Painful muscle spasms and paresthesias in the arms and legs may also appear. Neurological disorders can manifest themselves as a weakening of the tendon reflexes or their complete cancellation.
Cardiac arrhythmias are a very serious and dangerous consequence of hypokalemia. Additional stimulation or supraventricular tachycardia are perceived by the patient as the so-called "palpitations".
There may also appear the so-called heart blocks. Simply put, these are conditions in which the time between individual heart contractions is dangerously prolonged. The most serious condition - and directly life-threatening in hypokalemia, is ventricular fibrillation. Their fast and uncoordinated work completely impairs the ejection of blood from the heart to the aorta, and thus its distribution around the body. The only treatment option in this case is CPR and defibrillation.
The cause of death in patients with severe hypokalemia may also be rhabdomyolysis - that is, the breakdown of striated muscle tissue. Eventually, it leads to acute renal failure. It is a disease state that is completely reversible when detected early. Symptoms of hypokalemia resolve afterbalance electrolyte disturbances.
Hypokalemia: diagnosis
The most important part of the diagnostic process in hypokalemia is the determination of the concentration of potassium ions in the blood serum. At the same time, the doctor should take a detailed interview, bearing in mind such reasons as the use of diuretics or symptoms of endocrine disorders.
Hypokalemia: treatment
The cause of the low potassium level in the body must be removed first. The next step will be to equalize its level and treat other frequently accompanying water and electrolyte disturbances, e.g. metabolic acidosis.
We can compensate for mild stages of hypokalemia by consuming fruits rich in potassium (bananas, fruit juices), leveling significant deficiencies may require the supply of oral preparations, usually in the form of potassium chloride (KCl).
Severe hypokalemia associated with cardiac dysfunction is an indication for the supply of potassium parenterally, with simultaneous monitoring of the level of the element in the serum. This is to avoid drug overdose and induction of hyperkalemia.
Refractory hypokalaemia may result from accompanying hypomagnesaemia. Treatment of hypokalemia must be under the supervision of a doctor because it is very easy to overdose preparations and cause many side effects.Source:http: //onlinelibrary.wiley.com/doi/10.1111/ j.1742-1241.2009.02051.x / full