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Hypokalemia - Differential Diagnosis Algorithm

Transcellular Shift:
 • Alkalosis
 • ↑ beta-2 adrenergic simulation 
 • Erythropoiesis
Transcellular Shift ... Medications Renal ... Losses Non-renal ... Diagnosis #Algorithm #nephrology ... #low #potassium
Causes of Hyperkalemia

Hyperkalemia is caused by excess potassium intake, impaired potassium excretion, or transcellular shifts. The
Causes of Hyperkalemia ... potassium intake ... transcellular shifts ... with impaired renal ... and underlying renal
Causes of Hyperkalemia - Differential Diagnosis Algorithm
 • Increased Intake
 • Reduced Excretion (IV potassium with
Causes of Hyperkalemia ... Excretion (IV potassium ... Transcellular Shift ... #Hyperkalemia ... #Nephrology #Differential
Hyperkalemia: Diagnostic algorithm
Decreased renal potassium excretion
 • Acute renal failure
 • Chronic renal failure
 • Drugs
Increased
Hyperkalemia: Diagnostic ... Normal, Renin High ... hypoplasia Aldosterone high ... • Type 1 #Hyperkalemia ... Diagnosis #algorithm #nephrology
Hyperkalemia Treatment Options
Stabilize cardiac membrane:
 • IV Calcium (peaks 5-10 minutes)
Decrease potassium concentration:
 • IV Fluids
Shift
Hyperkalemia Treatment ... • IV Fluids Shift ... (if preserved renal ... LouLectures #Hyperkalemia ... #nephrology
Hypokalemia Differential Diagnosis Algorithm

Low intake 
• poor oral intake 

Renal loss 
• Medication 
• Hypomagnesemia 
•
Hypokalemia Differential ... oral intake Renal ... Nonreabsorbable anions • Renal ... Transcellular shift ... Diagnosis #Algorithm #Causes
Hypokalemia - Differential Diagnosis Algorithm
Extra-renal Losses:
 • Normal Acid-Base: Low intake
 • Metabolic acidosis: Gl tract
Algorithm Extra-renal ... Syndrome • HTN, High ... Diagnosis #Algorithm #causes ... #potassium #low ... #nephrology
Hyperkalemia - Differential Diagnosis Framework

PseudoHyperkalemia:
 • Lab error
 • Traumatic venipuncture
 • Hemolysis, thrombocytosis, leukocytosis
 •
phlebotomy High ... Intracellular Shift ... differential #diagnosis #causes ... #potassium #high ... #nephrology
Causes of Hypokalemia - Differential Diagnosis Algorithm
Defining the cause of hypokalemia starts by measuring urinary K
Causes of Hypokalemia ... Defining the cause ... gastrointestinal K loss • Renal ... • Renal tubular ... #nephrology #potassium
Causes of Hypokalemia - Differential Diagnosis Algorithm
Increased Loss 
 - Increased GI Loss
 - Increased Urinary
Causes of Hypokalemia ... Transcellular Shift ... Refeeding Syndrome #Hypokalemia ... Diagnosis #Algorithm #causes ... #potassium #low