Chapter 046. Sodium and Water (Part 12)

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Table 46-3 Causes of Hypokalemia I. Decreased intake A. Starvation B. Clay ingestion II. Redistribution into cells A. Acid-base 1. Metabolic alkalosis B. Hormonal 1. Insulin 2. β2-Adrenergic agonists (endogenous or exogenous) 3. α-Adrenergic antagonists C. Anabolic state 1. Vitamin B12 or folic acid (red blood cell production) 2. Granulocyte-macrophage colony stimulating factor (white blood cell production) 3. Total parenteral nutrition D. Other 1. Pseudohypokalemia 2. Hypothermia 3. Hypokalemic periodic paralysis 4. Barium toxicity III. Increased loss A. Nonrenal 1. Gastrointestinal loss (diarrhea) 2. Integumentary loss (sweat) B. Renal 1. Increased distal flow: diuretics, osmotic diuresis, salt-wasting nephropathies ...

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Chapter 046. Sodium and Water (Part 12) Table 46-3 Causes of Hypokalemia I. Decreased intake A. Starvation B. Clay ingestion II. Redistribution into cells A. Acid-base
1. Metabolic alkalosis B. Hormonal 1. Insulin 2. β2-Adrenergic agonists (endogenous or exogenous) 3. α-Adrenergic antagonists C. Anabolic state 1. Vitamin B12 or folic acid (red blood cell production) 2. Granulocyte-macrophage colony stimulating factor (white blood cell production) 3. Total parenteral nutrition
D. Other 1. Pseudohypokalemia 2. Hypothermia 3. Hypokalemic periodic paralysis 4. Barium toxicity III. Increased loss A. Nonrenal 1. Gastrointestinal loss (diarrhea) 2. Integumentary loss (sweat) B. Renal 1. Increased distal flow: diuretics, osmotic
diuresis, salt-wasting nephropathies 2. Increased secretion of potassium a. Mineralocorticoid excess: primary hyperaldosteronism, secondary hyperaldosteronism (malignant hypertension, renin-secreting tumors, renal artery stenosis, hypovolemia), apparent mineralocorticoid excess (licorice, chewing tobacco, carbenoxolone), congenital adrenal hyperplasia, Cushing's syndrome, Bartter's syndrome b. Distal delivery of non-reabsorbed anions: vomiting, nasogastric suction, proximal (type 2) renal tubular acidosis, diabetic ketoacidosis, glue-sniffing (toluene abuse), penicillin derivatives
c. Other: amphotericin B, Liddle's syndrome, hypomagnesemia