Chapter 046. Sodium and Water (Part 12)

Table 46-3 Causes of HypokalemiaI. Decreased intakeA. StarvationB. Clay ingestionII. Redistribution into cellsA. Acid-base1. Metabolic alkalosisB. Hormonal1. Insulin2.β2-Adrenergicagonists(endogenousorexogenous)3. α-Adrenergic antagonistsC. Anabolic state1. Vitamin B12 or folic acid (red blood cell production)2. Granulocyte-macrophage colony stimulating factor (white blood cell production)3. Total parenteral nutritionD. Other1. Pseudohypokalemia2. Hypothermia3. Hypokalemic periodic paralysis4. Barium toxicityIII. Increased lossA. Nonrenal1. Gastrointestinal loss (diarrhea)2. Integumentary loss (sweat)B. Renal1. Increased distal flow: diuretics, osmoticdiuresis, salt-wasting nephropathies ...
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Chapter 046. Sodium and Water (Part 12) Chapter 046. Sodium and Water (Part 12)Table 46-3 Causes of Hypokalemia I. Decreased intake A. Starvation B. Clay ingestion II. Redistribution into cells A. Acid-base 1. Metabolic alkalosisB. Hormonal 1. Insulin 2. β2-Adrenergic agonists (endogenous or exogenous) 3. α-Adrenergic antagonistsC. Anabolic state 1. Vitamin B12 or folic acid (red blood cell production) 2. Granulocyte-macrophage colony stimulating factor (white blood cell production) 3. Total parenteral nutrition D. Other 1. Pseudohypokalemia 2. Hypothermia 3. Hypokalemic periodic paralysis 4. Barium toxicityIII. Increased loss A. Nonrenal 1. Gastrointestinal loss (diarrhea) 2. Integumentary loss (sweat) B. Renal 1. Increased distal flow: diuretics, osmoticdiuresis, salt-wasting nephropathies 2. Increased secretion of potassium a. Mineralocorticoid excess: primary hyperaldosteronism, secondary hyperaldosteronism (malignant hypertension, renin-secreting tumors, renal artery stenosis, hypovolemia), apparent mineralocorticoid excess (licorice, chewing tobacco, carbenoxolone), congenital adrenal hyperplasia, Cushings syndrome, Bartters syndrome b. Distal delivery of non-reabsorbed anions: vomiting, nasogastric suction, proximal (type 2) renal tubular acidosis, diabetic ketoacidosis, glue-sniffing (toluene abuse), penicillin derivatives c. Other: amphotericin B, Liddlessyndrome, hypomagnesemia