Family Health
Bookmark and Share
Metabolic Disorders
Calcium Imbalance
Chloride Imbalance
Gaucher's Disease
Glycogen Storage Diseases
Lactose Intolerance
Magnesium Imbalance
Metabolic Acidosis
Metabolic Alkalosis
Phosphorus Imbalance
Potassium Imbalance
Sodium Imbalance
Syndrome of Inappropriate Antidiuretic Hormone Secretion
Tay-Sachs Disease

Potassium Imbalance

What is Potassium Imbalance ?

Potassium - a cation and the dominant cellular electrolyte-facilitates contraction of both skeletal and smooth muscles, including myocardial contraction. It figures prominently in nerve impulse conduction, acid-base balance, enzyme action, and cell membrane function. Because serum potassium level has such a narrow range (3.5 to 5 mEq/L), a slight deviation in either direction can produce profound consequences.

Causes of Potassium Imbalance

Hypokalemia rarely results from a dietary deficiency because many foods contain potassium. Instead, potassium loss results from:

  • excessive GI losses, such as vomiting, gastric suction, diarrhea, villous adenoma, and laxative abuse
  • chronic renal disease, with tubular potassium wasting
  • certain drugs, especially potassium-wasting diuretics, steroids, and certain sodium-containing antibiotics (carbenicillin)
  • alkalosis or insulin effect, which causes potassium shifting into cells without depletion of total body potassium
  • prolonged potassium-free l.V. therapy
  • hyperglycemia, causing osmotic diuresis and glycosuria
  • Cushing's syndrome, primary hyperaldosteronism, excessive ingestion of licorice, and severe serum magnesium deficiency.

Hyperkalemia usually results from reduced excretion by the kidneys. This may be due to acute or severe chronic renal failure, oliguria due to shock or severe dehydration, or the use of potassium-sparing diuretics such as triamterene by patients with renal disease. Inadequate potassium excretion may also be due to hyperaldosteronism or Addison's disease.

Hyperkalemia may also result from failure to excrete excessive amounts of potassium infused l.V. or administered orally. Another cause is massive release of intracellular potassium, such as can occur with burns, crushing injuries, severe infection, or acidosis.

Signs & Symptoms of Potassium Imbalance

Signs of potassium deficiency include:

  • slow thought processes
  • abnormally dry skin
  • depression
  • reduced bowel sounds
  • anorexia
  • abdominal distension
  • edema
  • nervousness
  • irregular heartbeat
  • high cholesterol levels
  • muscular fatigue
  • growth impairment
  • headaches
  • proteinuria and glucose intolerance

Electrocardiograph changes accompanying hypokalemia are ST depression, flat T waves, U waves and dysrhythmias. The pulse will be fast, then slow. If digitalized, monitor for digitalis toxicity.

Diagnostic Tests

Serum potassium levels allow definitive diagnosis of a porassium abnormality. In hypokalemia, potassium levels are less than 3.5 mEq/L. In hyperkalemia, levels are more than 5 mEq/L.

Additional tests may be necessary to determine the underlying cause of the imbalance.


Hypokalemia treatment should involve increased dietary intake of potassium or oral supplements with potassium salts. Potassium chloride is the preferred choice. Edematous patients with diuretic-induced hypokalemia should receive a potassium-sparing diuretic such as spironolactone.

Patients with GI potassium loss or severe potassium depletion require I.V. potassium replacement therapy. If hypocalcemia is also present, treatment should include calcium replacement.

For patients with hyperkalemia, treatment consists of withholding potassium and administering a carion exchange resin orally or by enema. Sodium polystyrene sulfonate (Kayexalate) with 70% sorbitol exchanges sodium ions for potassium ions in the intestine.

In an emergency, rapid infusion of 10% calcium gluconate decreases myocardial irritability and temporarily prevents cardiac arrest but doesn't correct serum potassium excess; it's also contraindicated in patients receiving digoxin.

Also as an emergency measure, sodium bicarbonate I.V. increases pH and causes potassium to shift back into the cells. Insulin and 10% to 50% glucose I.V. also move potassium back into cells. Infusions should be followed by dextrose 5% in water because infusion of 10% to 15% glucose stimulates secretion of endogenous insulin. Hemodialysis or peritoneal dialysis also helps remove excess potassium, but these are slow techniques.
Prevention Tips
  • If you take digitalis and diuretics, have frequent blood studies to monitor potassium levels.
  • Learn as much as you can about your condition, your drugs and how you can prevent a potassium imbalance.

(c)Copyright All rights reserved

Disclaimer :- The content in this web site are in no way intended to replace the professional medical care, advice, diagnosis or treatment of a doctor. The web site is build for information and educational purpose only. If you are ill from any disease or notice medical symptoms, you should consult your doctor. We will not be liable for any complications or other medical accidents arising from or in connection with the use of or reliance upon any information in this web site.