Hipokaliemii

Hipokaliemii, or hypokalemia, is a condition defined by low potassium in the blood. Normal serum potassium is about 3.5–5.0 mmol/L. Hypokalemia is below 3.5 mmol/L, with mild (3.0–3.4), moderate (2.5–2.9), and severe (<2.5).

Causes include increased losses (gastrointestinal losses from vomiting or diarrhea; renal losses from diuretics or hyperaldosteronism), cellular shifts into cells (alkalosis, insulin, catecholamines), and insufficient intake. Medications such as loop or thiazide diuretics, laxatives, and certain drugs can contribute; rare genetic disorders exist.

Symptoms vary; many patients are asymptomatic until levels fall below 3.0. Common signs are muscle weakness or cramps, fatigue, and constipation. Severe hypokalemia can cause paralysis, arrhythmias, or respiratory issues. ECG changes include flattened T waves, prominent U waves, ST depression, and prolonged QT.

Diagnosis rests on serum potassium measurement, kidney function, and acid–base status. Urinary potassium helps distinguish renal from extrarenal loss. Additional tests target suspected causes.

Treatment depends on severity. Mild cases may use oral potassium chloride in divided doses (roughly 40–100 mEq/day). Moderate to severe cases or those with symptoms require monitored IV replacement, usually not more than 10 mEq/hour, with ECG monitoring. Replete magnesium if deficient and address the underlying cause.

Prognosis is generally favorable with proper correction. Hypokalemia is common in hospitalized patients, often due to diuretics, making electrolyte monitoring important to prevent complications.