dhypokaliémie

Hypokaliémie, sometimes referred to as hypokalémie or, less commonly, as dhypokaliémie in certain sources, is a lower-than-normal concentration of potassium in the blood. In adults, the normal serum potassium range is about 3.5 to 5.0 mmol/L; hypokaliémie is typically defined as a value below 3.5 mmol/L and becomes clinically significant when it falls further, increasing the risk of cardiac and neuromuscular complications.

Causes are diverse and include decreased intake (rare on its own), gastrointestinal losses such as vomiting and diarrhea, renal losses often related to diuretic use or mineralocorticoid excess, and shifts of potassium from extracellular to intracellular compartments (as seen with insulin administration, beta-adrenergic stimulation, or alkalosis). Medications such as loop and thiazide diuretics, certain laxatives, and amphotericin B can contribute. Additionally, redistribution disorders, renal tubular disorders, and conditions like eating disorders may play a role.

Symptoms can be subtle or prominent and include muscle weakness, cramps, fatigue, constipation, and, in more severe cases, palpitations or arrhythmias. Electrocardiographic changes may include flattened or inverted T waves and the appearance of U waves; severe hypokaliémie can predispose to dangerous arrhythmias.

Diagnosis relies on a blood test to measure serum potassium, with evaluation of concomitant factors such as acid-base status, renal function, and magnesium level. Urine potassium and the fractional excretion of potassium help distinguish renal from extrarenal losses.

Treatment focuses on correcting potassium levels while addressing the underlying cause. Mild cases may be managed with oral potassium supplementation; more severe or symptomatic cases require intravenous potassium with careful monitoring to avoid overcorrection and cardiac complications. Magnesium replacement is often needed if magnesium is depleted. Prevention involves cautious use of diuretics, monitoring at-risk patients, and maintaining adequate intake.