K

Approach to Dyskalemias

Hypokalemia Hyperkalemia Transcellular shift Insulin, alkalemia, catecholamines, hypokalemic periodic paralysis Cell lysis, ↓ insulin, metabolic acidosis, β-blockers, hyperkalemic periodic paralysis Change in K+ content (nonrenal causes) Dx: [K+] < 25 mEq/d or TTKG < 2 Examples: Poor intake or GI loss Dx: TTKG > 10 Examples: Salt substitutes, tomatoes, potatoes, bananas, oranges Change in K+ content (renal causes) Dx: TTKG > 4 Dx: TTKG < 7 Examples: Enhanced diuresis, increased luminal gradient (hyperaldosteronism, Liddle's syndrome, nonreabsorbed anion) Examples: Acute/chronic kidney disease, hypoaldosteronism, type 4 RTA