Hipokalemia (Kiwango cha Chini cha Potasiamu katika Damu)

NaJames L. Lewis III, MD, Brookwood Baptist Health and Saint Vincent’s Ascension Health, Birmingham
Imepitiwa/Imerekebishwa Sept 2023

In hypokalemia, the level of potassium in blood is too low.

  • A low potassium level has many causes but usually results from vomiting, diarrhea, adrenal gland disorders, or use of diuretics.

  • A low potassium level can make muscles feel weak, cramp, twitch, or even become paralyzed, and abnormal heart rhythms may develop.

  • The diagnosis is based on blood tests to measure the potassium level.

  • Usually, eating foods rich in potassium or taking potassium supplements by mouth is all that is needed.

(See also Overview of Electrolytes and Overview of Potassium's Role in the Body.)

Potassium is one of the body's electrolytes, which are minerals that carry an electric charge when dissolved in body fluids such as blood. Potassium is needed for cells, muscles, and nerves to function correctly.

Sababu za Hipokalemia

Typically, the potassium level becomes low because too much is lost from the digestive tract due to vomiting, diarrhea, or excessive laxative use.

Sometimes too much potassium is excreted in urine, usually because the person is using medications that cause the kidneys to excrete excess sodium, water, and potassium (diuretics).

In many adrenal disorders, such as Cushing syndrome, the adrenal glands produce too much aldosterone, a hormone that causes the kidneys to excrete large amounts of potassium.

Certain medications (such as insulin, albuterol, and terbutaline) cause more potassium to move from blood into cells and can result in hypokalemia. However, these medications usually cause temporary hypokalemia, unless another condition is also causing potassium to be lost.

Hypokalemia sometimes occurs with or is caused by a low level of magnesium in the blood (hypomagnesemia).

Hypokalemia is rarely caused by consuming too little potassium because many foods (such as beans, dark leafy greens, potatoes, fish, and bananas) contain potassium.

Jedwali
Jedwali

Dalili za Hipokalemia

A slight decrease in the potassium level in blood usually causes no symptoms.

A larger decrease can cause muscle weakness, cramping, twitches, and even paralysis.

Abnormal heart rhythms may develop. They may develop even when the decrease is slight if people already have a heart disorder or take the heart medication digoxin.

If hypokalemia lasts for an extended time, kidney problems may develop, causing the person to urinate frequently and drink large amounts of water.

Utambuzi wa Ugonjwa wa Hipokalemia

  • Measurement of the potassium level in the blood

  • Electrocardiography

  • Sometimes measurement of the amount of potassium in urine

The diagnosis is made by measuring a low potassium level in the blood. Doctors then try to identify what is causing the potassium level to decrease.

The cause may be clear based on the person’s symptoms (such as vomiting) or use of medications or other substances. If the cause is not clear, doctors measure how much potassium is excreted in urine to determine whether excess excretion is the cause.

Because low potassium levels can cause abnormal heart rhythms, doctors usually do electrocardiography (ECG) to check for abnormal rhythms.

Matibabu ya Hipokalemia

  • Potassium supplements

If a disorder is causing hypokalemia, it is treated.

Usually, potassium can be replaced by taking potassium supplements by mouth. Because potassium can irritate the digestive tract, supplements should be taken in small doses with food several times a day rather than in a single large dose. Special types of potassium supplements, such as wax-impregnated or microencapsulated potassium chloride, are much less likely to irritate the digestive tract.

To treat hypokalemia more rapidly, potassium is given by vein (intravenously) in the following situations:

  • The potassium level is dangerously low.

  • The low level causes abnormal heart rhythms.

  • Supplements taken by mouth are ineffective.

  • People continue to lose more potassium than can be replaced using supplements taken by mouth.

Most people who take diuretics do not need to take potassium supplements. Nevertheless, doctors periodically check the potassium level in the blood so that supplements can be given if necessary. Alternatively, diuretics that help the kidneys conserve potassium (potassium-sparing diuretics), such as amiloride, eplerenone, spironolactone, or triamterene can be used, but these medications are used only if the kidneys are functioning normally.

When hypomagnesemia occurs with hypokalemia, it too is treated.