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Hypokalemia - Differential Diagnosis Algorithm

Transcellular Shift:
 • Alkalosis
 • ↑ beta-2 adrenergic simulation 
 • Erythropoiesis
Transcellular Shift ... Thyrotoxicosis Medications ... Transcellular shifts ... • Discontinued diuretic ... nephrology #low #potassium
Treatment of hyperkalemia via kaliuresis 
step 1 = volume resuscitation if hypovolemic
step 2 = consider fludrocortisone
step
Treatment of hyperkalemia ... #hyperkalemia ... kaliuresis #management #criticalcare ... #treatment #diuretics ... #diuresis #nephrology
Hypokalemia Differential Diagnosis Algorithm

Low intake 
• poor oral intake 

Renal loss 
• Medication 
• Hypomagnesemia 
•
Hypokalemia Differential ... Renal loss • Medication ... Hypomagnesemia • Osmotic diuresis ... Transcellular shift ... Hypothermia • Hypokalemic
Hyperkalemia Treatment Options
Stabilize cardiac membrane:
 • IV Calcium (peaks 5-10 minutes)
Decrease potassium concentration:
 • IV Fluids
Shift
Hyperkalemia Treatment ... minutes) Decrease potassium ... • IV Fluids Shift ... function) - Loop diuretic ... LouLectures #Hyperkalemia
Mechanisms of Drug-Induced Hyperkalemia 
 • Direct renin inhibitor (Aliskiren)
 • Renin release inhibition (NSAIDs, Beta-Blockers)
of Drug-Induced Hyperkalemia ... Angiotensin-converting enzyme (ACE ... • Increased EC shift ... #pharmacology #potassium ... #medications #druginduced
Causes of Hypokalemia
Transcellular Shifts:
 - Alkalosis, Increased plasma insulin (treatment of diabetic ketoacidosis), ß-Adrenergic agonists, Hypokalemic
Causes of Hypokalemia ... Transcellular Shifts ... plasma insulin (treatment ... ß-Adrenergic agonists, Hypokalemic ... congenital), Thyrotoxic hypokalemic
Causes of Hyperkalemia

Hyperkalemia is caused by excess potassium intake, impaired potassium excretion, or transcellular shifts. The
caused by excess potassium ... intake, impaired potassium ... transcellular shifts ... renal function, medication ... adapt to excess potassium
Medications for the Treatment of Hyperkalemia
The goals of acute treatment are to prevent potentially life-threatening cardiac
Medications for ... the Treatment of ... disturbances, shift ... Table 3 summarizes medications ... #Management #Medications
Hyperkalemia - Diagnosis and Management - GrepMed Handbook

S/Sx: Most pts asymptomatic. Weakness, cramping, nausea, paresthesias, palpitations,
Etiology: • Medications ... : K+, ACEi/ARBs, ... STOP offending medications ... Redistribution Treatments ... #potassium #nephrology
Algorithm for patients with hypokalemia on the basis of the potassium-to-creatinine ratio in the urine
Urine K+
the basis of the potassium-to-creatinine ... creatinine) • Cell shift ... Urine Cl - Loop diuretics ... , Thiazide diuretics ... #urine #potassium