Hypokalemia

Abnormally low potassium concentration in the blood. It may result from potassium loss by renal secretion or by the gastrointestinal route, as by vomiting or diarrhea. It may be manifested clinically by neuromuscular disorders ranging from weakness to paralysis, by electrocardiographic abnormalities (depression of the T wave and elevation of the U wave), by renal disease, and by gastrointestinal disorders. (Dorland, 27th ed)

Also Known As:

Networked: 3000 relevant articles (110 outcomes, 167 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Hypertension (High Blood Pressure)
2.	Hyperaldosteronism (Conn Syndrome)
3.	Acidosis
4.	Hypocalcemia
5.	Hyperkalemia

Experts

1.	Lin, Shih-Hua: 23 articles (09/2015 - 05/2002)
2.	Sasano, Hironobu: 9 articles (01/2014 - 03/2002)
3.	Pitt, Bertram: 8 articles (01/2015 - 04/2003)
4.	Yang, Sung-Sen: 7 articles (03/2015 - 05/2002)
5.	Tajima, Toshihiro: 7 articles (01/2014 - 02/2002)
6.	Weber, Karl T: 7 articles (09/2013 - 07/2005)
7.	Chau, Tom: 6 articles (03/2015 - 05/2002)
8.	Cheng, Chih-Jen: 6 articles (03/2015 - 09/2005)
9.	Bianchetti, Mario G: 6 articles (01/2015 - 08/2002)
10.	Weiss, James N: 5 articles (10/2015 - 08/2010)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Hypokalemia:

1.	PotassiumIBA 01/01/2002 - "Since potassium depletion rarely occurs as an isolated phenomenon, associated fluid and electrolyte disorders should be corrected, and the causes of potassium loss should be sought and eliminated to complete the treatment of hypokalemia." 06/01/2000 - "Our studies demonstrated that the incidence of PA is 5.4%, and also that the plasma potassium level is not always beneficial for suspecting the presence of PA, because 28% of the patients with PA show only hypokalemia. " 03/21/1985 - "We conclude that short-term potassium supplementation that ameliorates diuretic-induced hypokalemia may induce a significant fall in blood pressure." 05/04/1999 - "Potassium supplementation may be effective in reducing blood pressure in patients with hypokalemia during diuretic therapy. " 06/15/1984 - "This study examines the efficacy of supplemental potassium in treating this hypokalemia. "
2.	AldosteroneIBA 12/01/2015 - "Therefore, the aim of treatment should not be confined to BP normalization and hypokalemia correction, but rather should focus on restoring the deleterious effects of excess aldosterone on the cardiovascular system. " 06/01/2015 - "However, the influence of aldosterone on microvascular endothelial function and the effect of hypokalemia on the vascular structure still remain unclear. " 11/01/2014 - "Young individuals with normal CT adrenals rarely lateralized (10 %) and, in such patients, even factors like hypokalemia, body mass index (BMI), and plasma aldosterone level did not change the result on regression analysis. " 08/01/2012 - "In addition to male patients having an earlier age of onset, more severe hypokalemia, and significantly lower serum aldosterone concentration, patients with homozygous and deep mutations in intron 13 (c.1670-191C → T) had more severe phenotype. " 01/01/2009 - "Elevated plasma aldosterone concentration and hypokalemia were observed, and an magnetic resonance imaging scan demonstrated a right adrenal mass. "
3.	Spironolactone (Aldactone)FDA LinkGeneric 12/01/2010 - "Patients who received spironolactone were significantly less likely to experience mild, moderate, or severe hypokalemia (8.8%, 2.9%, and 0) compared with controls (29.4%, 11.7%, and 2.9%, respectively, P less than 0.05). " 12/01/2010 - "We evaluated the effect of spironolactone on preventing hypokalemia following moderate to severe TBI. " 02/01/2000 - "At therapeutic doses of 25 to 400 mg per day, spironolactone effectively controls blood pressure and hypokalemia in the majority of cases. " 01/01/1993 - "This side effect is functionally correlated with hypokalemia and therefore is not seen when patients are given a comedication (for example, spironolactone prevents hypokalemia). " 08/01/1984 - "The tetanic symptoms became extinct during the treatment with spironolactone against hypopotassemia. "
4.	Potassium ChlorideFDA LinkGeneric 05/01/1994 - "Controlled infusion of a concentrated solution of potassium chloride at a rate of 0.25 mmol/kg/hour is a safe and effective way to achieve rapid correction of hypokalemia with ECG changes, using minimal fluid volumes." 05/01/1994 - "Safety and efficacy of a concentrated potassium chloride solution infusion for rapid correction of hypokalemia." 03/01/2014 - "Efficacy of oral potassium chloride administration in treating lactating dairy cows with experimentally induced hypokalemia, hypochloremia, and alkalemia." 12/01/2012 - "Moderate hypokalemia occurred once in one subject in the MN-221-CL-004 study and twice in one subject in the MN-221-CL-005 study and were transient and returned to normal range following single oral potassium chloride treatments. " 09/01/2015 - "Exclusion of TPP can be accomplished by immediate evaluation of urinary K+ excretion, acid-base status, and the amount of potassium chloride required to correct hypokalemia at presentation."
5.	ReninIBA 11/01/2015 - "All patients had hypokalemia and suppressed plasma renin activity. " 03/01/2015 - "During therapy, patients with paradoxical hypokalemia (n = 32) who required more KCl supplementation than patients without (4.1 ± 0.7 vs 3.4 ± 0.7 mmol/kg, P < 0.001) often exhibited significantly higher plasma renin activity and received a higher volume of normal saline before its appearance. " 01/01/2010 - "Laboratory findings showed severe hypokalemia and markedly increased plasma renin activity. " 09/01/2002 - "The diagnosis was suggested by marked hypokalemia, and was confirmed by hyperaldosteronaemia and low and poorly stimulated renin activity. " 01/01/1999 - "These results suggest that activation of the sympathetic nervous system plays a role in alcohol-induced cardiac stimulation, renin release and hypokalemia through beta receptors. "
6.	MagnesiumIBA 04/01/2012 - "Investigations showed hypokalemia and hypomagnesemia with urinary magnesium wasting. " 01/01/2012 - "Investigations showed hypokalemia and hypomagnesemia with urinary magnesium wasting. " 04/01/2009 - "Magnesium has been directly implicated in hypokalemia, hypocalcaemia and dysrrthymias. " 03/01/2002 - "Magnesium deficit is not infrequently observed in CHF patients but its pathophysiology remains less well-studied as compared with other electrolyte alterations, such as hypokalemia. " 05/01/1998 - "Magnesium depletion and experience with supplementation appear to have most significance in diabetic ketoacidotic patients with the development of associated refractory hypokalemia. "
7.	SodiumIBA 05/01/1993 - "These studies suggest that amelioration of hypokalemia attenuates mineralocorticoid-induced sodium retention. " 05/01/2013 - "In most cases, it is a result of diuretic therapy, which causes activation of the renin-angiotensin system, chloride depletion, increased distal sodium delivery, hypokalemia, and increased urine acidification, all of which contribute to bicarbonate retention. " 07/01/2011 - "The mean serum sodium concentration on presentation was 110.9 ± 5.9 mmol/L and was associated with findings of hypokalemia in ten patients and hypomagnesemia in eight patients. " 03/01/2011 - "During the adaptation to high-sodium diet, heterozygotes displayed impaired sodium excretion, a transient positive sodium balance, and hypokalemia. " 02/01/2011 - "In patients with hypokalemia (plasma K(+) concentration <3.5 mmol/l), after the exclusion of extrarenal causes, alterations in sodium ion delivery to the distal nephron, mineralocorticoid status, or a specific inherited or acquired defect in distal nephron function (each of which affects distal nephron K(+) secretion), should be considered. "
8.	Insulin (Novolin)FDA Link 08/01/2011 - "Major new findings are: Protection against terbutalin induced further reduction in pK in severe pre-existing hypokalemia (<2 mm) and blunted but nevertheless severe further reduction in pK in more moderate pre-existing hypokalemia; immediate abolishment of protection by normalization of pK; protection against additive reduction in pK by terbutalin and insulin in severe hypokalemia. " 02/01/2009 - "The present study thus explored the contribution of SGK1 to insulin-induced hypokalemia. " 11/01/2004 - "This study addressed whether the DEX-induced increase in the muscle NKA pool leads to increased insulin-stimulated cellular K+ uptake that could precipitate hypokalemia. " 07/01/2013 - "Hypokalemia was a delayed complication of DKA treatment in the PCCU, associated with high K(+) and Na(+) excretion rates and a prolonged infusion of high doses of insulin." 07/01/2013 - "At peak kaliuresis, insulin dose was higher in the hypokalemia group (median 0.07, range 0-0.24 vs median 0.025, range 0-0.05 IU/kg; P = .01), and there was a significant correlation between K(+) and Na(+) excretion (r = 0.67, P < .0001). "
9.	CalciumIBA 12/15/1994 - "The measurement of the urinary calcium excretion in patients with an unclear hypokalemia-hypomagnesemia-syndrome allows easily the differentiation between Bartter's and Gitelman's syndrome." 02/01/1993 - "The long-term follow-up (from age 6 to 20 years) of a girl with Gitelman's syndrome, who had four hypomagnesaemic-tetanic episodes associated with normal plasma calcium, hypokalemia and hypocalciuria, is presented. " 12/01/1988 - "Heart mitochondrial calcium content was elevated in parallel with the decrease in serum K+ in dogs with hypokalemia. " 11/01/1977 - "In addition, the degree and frequency of hypokalemia were greatest at the higher serum calcium levels. " 01/01/2004 - "Laboratory studies revealed metabolic alkalosis with hypokalemia, hypomagnesemia and low calcium in a 24-hour urine test. "
10.	CreatinineIBA 07/01/2013 - "At nadir plasma K(+) concentration, urine K(+)-to-creatinine ratio and fractional excretion of K(+) were greater in patients who developed hypokalemia compared with those without hypokalemia (19.8 vs 6.7, P = .04; and 31.3% vs 9.4%, P = .004, respectively). " 08/01/2012 - "Among 119 patients (60 children, 59 adults) receiving AMB-D, serum creatinine doubling from baseline, hypokalemia and IRE occurred in 14.3 % (15 % in children, 13.6 % in adults), 16.8 % (16.6 % in children, 16.9 % in adults) and 10.9 % (10 % in children, 11.8 % in adults), respectively. " 01/01/2012 - "In linear regression model overall CA levels had correlation with lower age of recipient (P = 0.02), hypokalemia (P = 0.001), higher level of creatinine (P = 0.02) and triglyceride (P = 0.001). " 09/01/2010 - "No differences were detected in average decrease in creatinine clearance, incidence of nephrotoxicity, or rates of hypomagnesemia and hypokalemia. " 12/15/2007 - "A 2-fold increase in serum creatinine occurred in 4 of 17 patients (23%) who received high-dose monotherapy and 1 of 15 patient (7%) who received combination therapy; hypokalemia <3 mmol/L occurred in 3 patients and 2 patients, respectively. "

Therapies and Procedures

1.	Adrenalectomy 12/01/2009 - "After right adrenalectomy, blood pressure normalized and hypokalemia resolved. " 01/01/2009 - "A laparoscopic adrenalectomy was performed because of refractory hypokalemia. " 11/01/2005 - "After adrenalectomy by laparoscopy, her blood pressure was remarkably reduced and the hypokalemia also recovered. " 01/01/2004 - "Her blood pressure and hypokalemia returned to normal after adrenalectomy. " 03/01/1999 - "These patients had both severe hypokalemia, resistant to medical treatment and that subsided with bilateral adrenalectomy and supplementation with dexametasone. "
2.	Drug Therapy (Chemotherapy) 03/01/2009 - "A proper chemotherapy resulted in remission of the hypokalemia, but the hypothiroidism was not influenced during our observation period." 12/01/2013 - "Prolonged QT interval which is an important provocative factor for torsades de point commonly results from interactions between drug therapy, myocardial ischemia, and electrolyte disturbances such as hypokalemia or hypomagnesaemia. " 08/01/2009 - "Aloe-induced hypokalemia in a patient with breast cancer during chemotherapy." 09/01/1984 - "Evidence is suggestive that a subpopulation of patients receiving chemotherapy may develop a functional Bartter's syndrome, and it is important to consider this diagnosis in patients who develop hypokalemia subsequent to chemotherapy introduction." 05/01/1972 - "Hypocalcemia, hypomagnesemia and hypokalemia during chemotherapy of pulmonary tuberculosis."
3.	Fluid Therapy (Oral Rehydration Therapy) 03/01/1990 - "Our clinical observations suggested that vigorous fluid therapy in children often resulted in hypokalemia. " 01/01/1984 - " 3 patients (6.1%) showed hypokalemia 24 hours after oral rehydration was initiated. " 11/01/1980 - " Mean K absorption from 0-6 hours was significantly higher in the high K group, and they had no hypokalemia after oral rehydration; in contrast, 33% of the low K infants had hypokalemia. " 03/01/1990 - "Significant hypokalemia may occur after aggressive rehydration of critically ill pediatric patients." 03/01/1989 - "Excessive K supplementation is a common iatrogenic cause of hyperkalemia whereas fluid therapy is a common cause of iatrogenic hypokalemia. "
4.	Nephrectomy 01/01/2008 - "In multivariate analysis, preoperative hypokalemia, preoperative increased BUN concentration, and concurrent nephrectomy were significantly associated with a shorter survival time. " 02/21/1977 - "The subsequent decline of [K+] and the persistent hypokalemia were not affected significantly by nephrectomy. " 02/01/2012 - "Resistant hyponatremia and hypokalemia treated successfully with nephrectomy." 12/01/2008 - "After preoperative medication, open excision, including left radical nephrectomy and adrenalectomy, normalized the catecholamine urinary level, resolved hypokalemia, and improved hypertension. " 06/01/1994 - "We report a case of hyponatremia, polyuria-polydipsia, hypokalemia, nephrotic syndrome, and hypertension caused by unilateral renal ischemia, and the resolution after nephrectomy of the ischemic kidney. "
5.	Transplantation (Transplant Recipients) 08/15/2009 - "The only factor associated with a prolonged QTc interval in the post-transplantation period was hypokalemia, with a mean QTc of 468 +/- 37 ms (p = 0.047). " 01/06/2011 - "Long-term toxicities occurred in 2 patients: hypokalemia and tremor, both grade III, on days 370 and 361 after transplantation. " 11/01/1985 - "To our knowledge this is the first report of a case of hypokalemia secondary to primary hyperaldosteronism in a renal transplant recipient." 11/01/1985 - "Hypokalemia secondary to primary hyperaldosteronism in a renal transplant recipient." 11/01/1999 - "The most common transplantation related complications were fever, liver dysfunction and hypopotassemia, all of which can be cured by proper treatment. "