Life-threatening hypokalemia in hospitalized patients

J Halevy, M Gunsherowitz, J B Rosenfeld
Mineral and Electrolyte Metabolism 1988, 14 (2): 163-6
Severe life-threatening hypokalemia (serum potassium less than or equal to 2.5 mmol/l) was found in 0.03% of serum biochemical profiles within 13 years in a major university hospital in Israel. Out of 130 patients with hypokalemia of this magnitude, 84 (65%) were females and the mean age was 64 years. A combination of iatrogenic factors, including the administration of intravenous fluids with insufficient or no potassium (K) replacement and the use of K-depleting medications and insulin, was responsible for the hypokalemia in 68% of the patients. Gastrointestinal loss of K was the main cause of severe hypokalemia in 22% of the patients. It is concluded that severe hypokalemia in hospitalized patients is commonly the result of multiple iatrogenic factors and, therefore, can be prevented by frequent monitoring of serum K and appropriate K supplementation.


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