Potassium Disorders: Hypo- and Hyperkalemia

Hyperkalemia and hypokalemia are common electrolyte disturbances with underlying causes that may be categorized as altered excretion of potassium, altered potassium intake, or transcellular shifts. Some common causes of hypokalemia include gastrointestinal losses (diarrhea) and diuretics. Hyperkalemia may be secondary to kidney disease, extremely high glucose levels causing transcellular shifts, or medication use.

Severe potassium shifts can result in neuromuscular dysfunction and lethal cardiac conduction. For this reason, determining whether urgent intervention is indicated is extremely important. This can be ascertained through good history-taking and physical examination skills, augmented with electrocardiography and laboratory findings.

It is important for the clinician to understand the indications for urgent treatment of hypo- or hyperkalemia, as well as the common methods of treatment (e.g., oral or IV potassium and/or insulin and glucose) and the pros and cons of each.