Pragmatic diagnostic algorithm for hypokalemia. ***Typical presentations: • Vomiting: urine Na/Cl > 1.6, low urine Cl; • Laxative: urine Na/Cl < 0.7, high urine Cl; • Active diuretic use: similar to tubulopathy; • Tubulopathy: urine K/creatinine (Cr) > 2.5 mmol/mmol, with urine Na/Cl ~1. Tubulopathy may be confirmed via genetic testing *If hypokalemia seems disproportionately severe to the dose of diuretic, one may still consider aldosterone excess. **Ideally, after correcting serum potassium levels, with the patient not taking mineralocorticoid receptor antagonists. Other medications, including angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, may be continued in most cases; interpretation is dependent upon local laboratory methods and reporting.137,138 #hypokalemia #diagnosis #differential #algorithm #nephrology
