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HypoKalemia
Practical Approach
Mohammed Abdel Gawad
Nephrology Consultant - Alexandria - Egypt
MD Nephrology - Mansoura University - Egypt
European Specialty Examination in Nephrology (ESENeph)
NephroTube Founder/Admin
Member of ISN education SoMe team
Co-chair of AFRAN Web & Media Committee
drgawad@gmail.com
@Gawad_Nephro
NephroTube Webinar, 15-July-2021
Hypokalemia (Practical Approach) - Dr. Gawad
To download the lecture contact me
drgawad@gmail.com
For more Nephrology lectures visit
www.NephroTube.com
Hypokalemia is defined as a plasma potassium
concentration less than 3.5 mEq/L.
Talk Outline
• Presentation
• Normal potassium homeostasis
• Diagnostic approach
• Management
Talk Outline
• Presentation
• Normal potassium homeostasis
• Diagnostic approach
• Management
Presentation
Handbook of Critical Care Nephrology. Chapter 21. 2021
Talk Outline
• Presentation
• Normal potassium homeostasis
• Diagnostic approach
• Management
Talk Outline
• Presentation
• Normal potassium homeostasis
• Diagnostic approach
• Management
Clin J Am Soc Nephrol 10: 1050–1060, 2015
Pediatric Nephrology. Chapter 1. Arvind Bagga, RN Srivastava
Pediatric Nephrology. Chapter 1. Arvind Bagga, RN Srivastava
Clin J Am Soc Nephrol 10: 1050–1060, 2015
doi: 10.2215/CJN.08580813
Talk Outline
• Presentation
• Normal potassium homeostasis
• Diagnostic approach
• Management
Talk Outline
• Presentation
• Normal potassium homeostasis
• Diagnostic approach
• Management
Acta Med Indones. Jan-Mar 2007;39(1):56-64.
Hypokalemia (Practical Approach) - Dr. Gawad
Pharmacovigilance Forum.
Vol. 40 No. 3 • March 2015
Acta Med Indones. Jan-Mar 2007;39(1):56-64.
Acta Med Indones. Jan-Mar 2007;39(1):56-64.
Acta Med Indones. Jan-Mar 2007;39(1):56-64.
Acta Med Indones. Jan-Mar 2007;39(1):56-64.
Acta Med Indones. Jan-Mar 2007;39(1):56-64.
Acta Med Indones. Jan-Mar 2007;39(1):56-64.
Hypokalemia (Practical Approach) - Dr. Gawad
↑ Na loss
and polyuria
Volume depletion
↑aldosterone
section
K
H
↑ K loss and hypokalemia
+ metabolic alkalosis
↑ Na loss
and polyuria
Volume depletion
↑aldosterone
section
K
H
↑ K loss and hypokalemia
+ metabolic alkalosis
↑ Na loss
and polyuria
Volume depletion
↑aldosterone
section
K
H
↑ K loss and hypokalemia
+ metabolic alkalosis
↑ Na loss
and polyuria
Volume depletion
↑aldosterone
section
K
H
↑ K loss and hypokalemia
+ metabolic alkalosis
World J Methodol 2015 June 26; 5(2): 55-61
Acta Med Indones. Jan-Mar 2007;39(1):56-64.
Acta Med Indones. Jan-Mar 2007;39(1):56-64.
Glucocorticoid remediable aldosteronism
Acta Med Indones. Jan-Mar 2007;39(1):56-64.
Glucocorticoid remediable aldosteronism
Acta Med Indones. Jan-Mar 2007;39(1):56-64.
Familial Hyperaldosteronism Type 1
caused by a mutation that results in
aldosterone secretion falling under the control
of adrenocorticotropic hormone (ACTH) rather
than angiotensin
Glucocorticoid remediable aldosteronism
Acta Med Indones. Jan-Mar 2007;39(1):56-64.
Glucocorticoid remediable aldosteronism
Acta Med Indones. Jan-Mar 2007;39(1):56-64.
Glucocorticoid remediable aldosteronism
Acta Med Indones. Jan-Mar 2007;39(1):56-64.
overexpression
↑ BP ± edema ↓ aldosterone
April 09, 2012.
DOI: https://doi.org/10.1016/j.cjca.2012.01.002
Hypokalemia (Practical Approach) - Dr. Gawad
Glucocorticoid remediable aldosteronism
Acta Med Indones. Jan-Mar 2007;39(1):56-64.
Hypokalemia (Practical Approach) - Dr. Gawad
Glucocorticoid remediable aldosteronism
Acta Med Indones. Jan-Mar 2007;39(1):56-64.
Licorice-induced pseudohyperaldosteronism
Talk Outline
• Presentation
• Normal potassium homeostasis
• Diagnostic approach
• Management
Talk Outline
• Presentation
• Normal potassium homeostasis
• Diagnostic approach
• Management
Hypokalemia because of intracellular redistribution
of potassium as in the case of thyrotoxic periodic
paralysis or hypokalemic periodic paralysis can
often result in severe rebound hyperkalemia;
therefore, all hypokalemic patients need careful
monitoring of serum potassium levels following
treatment
Handbook of Critical Care Nephrology. Chapter 21. 2021
e.g. if potassium is 3.2 mEq/L then give: 4 - 3.2 X
100 = 80 mEq of potassium
Hypokalemia (Practical Approach) - Dr. Gawad
1 liter 1 liter
< 3mEq/L
> 3mEq/L
1 liter 1 liter
< 3mEq/L
> 3mEq/L
Danger of rapid onset hyperkalaemia →
recheck K +
Hypokalemia (Practical Approach) - Dr. Gawad

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