hipokalemii

Hipokalemii, or hypokalemia, is a medical condition characterized by lower-than-normal potassium levels in the blood. Potassium is essential for normal cellular function, particularly in skeletal and cardiac muscles, nerves, and acid-base balance. Serum potassium is usually considered low when it falls below 3.5 mEq/L. Symptoms can be absent or range from fatigue and muscle weakness to cramps and, in severe cases, life-threatening arrhythmias. The condition commonly prompts evaluation when an abnormal ECG or other clinical concerns arise rather than from symptoms alone.

Causes of hipokalemii are diverse. Gastrointestinal losses from vomiting or diarrhea and the use of laxatives can deplete potassium. Renal losses are common with diuretics (especially loop and thiazide diuretics), hyperaldosteronism, certain renal tubular disorders, and magnesium deficiency. Potassium can also shift intracellularly during processes such as insulin administration, alkalosis, or beta-adrenergic stimulation. Inadequate dietary intake is a rare contributor in developed settings. Some medications, including certain antibiotics, steroids, and others, can indirectly promote potassium loss.

Diagnosis relies on measuring serum potassium and assessing associated factors. Electrocardiographic changes typical of hypokalemia include flattened T waves, prominent U waves, ST-segment depression, and a prolonged QT interval. Evaluation often includes magnesium and bicarbonate levels, renal function, acid-base status, and sometimes urinary potassium excretion to distinguish renal from non-renal losses.

Management depends on severity and symptoms. Mild cases may be treated with oral potassium supplementation and monitoring. Moderate to severe hypokalemia or symptomatic patients require more rapid correction, generally with intravenous potassium chloride under careful supervision, with rates typically limited for peripheral administration. Magnesium repletion is necessary if deficient. Ongoing care focuses on addressing the underlying cause and preventing recurrence through medication adjustments and dietary measures. Prognosis improves with timely, appropriate treatment.