Hypokalaemia

Description

Diagnostic criteria

Medicine treatment

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ICD-10 Code: E87.6

DESCRIPTION
Causes include:

• prolonged decreased intake and protein energy malnutrition,
• increased renal excretion: renal tubular acidosis, amphoteracin B and diuretics;
• increased extra-renal losses,
• transmembrane shifts: ß₂ stimulants, alkalosis; and
• mineralocorticoid excess.

DIAGNOSTIC CRITERIA
Clinical

•     Cardiac arrhythmias, especially with digitalis.
•     Neuromuscular dysfunction, e.g. muscle weakness.
•     Renal: impairment of urine concentrating or diluting ability.

Investigations

•     Serum potassium < 3.0 mmol/L.

MEDICINE TREATMENT

See:  Alimentary Tract, Diarrhoea, acute.

Severe respiratory paralysis and or cardiac arrhythmias:

• Potassium chloride, IV, < 1 mEq/kg/hour.
  • ECG monitoring.
  • Potassium concentration should not be > 40 mmol/L/infusion.
  • Never give potassium as an IV bolus.

Less critical situations to correct potassium deficit over 2–3 days:

• Potassium chloride, oral, 2–6 mEq/kg/day.

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Note:

1 g KCl = 13 mEq

1 mL 15% KCl = 2 mmol

1 mEq = 1 mmol

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Standard Treatment Guidelines and Essential Medicines List for South Africa, Hospital Level, Paediatrics, 2023 Edition

Chapter 7: Endocrine, 7.10 Hypokalaemia