Conditions that contribute to K losses are excessive K urinary output and prolonged vomiting or diarrhea. Other causes include laxative abuse, diuretics, tumors (VIPoma, villous adenoma), burns, malnutrition, alcohol use disorder, excessive sweating, jejunoileal bypass, and renal tubular disease. Chemo and radiation therapies as well as a variety of medication classes can contribute to excessive potassium loss. These include bronchodilators, caffeine, mineralocorticoids, glucocorticoids, and penicillin in high doses. Excessive consumption of natural licorice is a less common cause.
Conditions that contribute to increased transfer of potassium into the cells are excessive insulin, insulin administered with dextrose or glucose (rather than saline solution), refeeding syndrome, and other drug-induced agents that elevate beta-adrenergic activity. Additional causes include hypothermia, alkalosis, increased extracellular pH, and toxicity of chloroquine, barium, and similar agents. Hypokalemic periodic paralysis is an autosomal dominant inherited disorder that can cause episodic muscle weakness when serum potassium levels are low.
Conditions that contribute to decreased K intake are usually in combination with other factors, and include potassium-deficient diet, parenteral therapy, folic acid deficiency, and malnutrition.
Signs and symptoms include neuromuscular abnormalities that can lead to severe muscle weakness, paralysis, muscular cramping, and rhabdomyolysis with myoglobinuria, as well as psychological symptoms including psychosis and delirium. Severe outcomes include cardiovascular arrhythmias (bradycardias), prolonged QT interval, renal impairment, and respiratory muscle weakness that can lead to respiratory failure and death.
E87.6 – Hypokalemia
43339004 – Hypokalemia