Potassium

Background

  • Primary intracellular cation; critical for cardiac and neuromuscular function
  • Only ~2% of total body potassium is extracellular; small changes in serum levels can be clinically significant

Normal Values

  • Normal: 3.5-5.0 mEq/L
  • Hypokalemia: <3.5 mEq/L
  • Hyperkalemia: >5.0 mEq/L

Interpretation

  • Hemolyzed specimens are the most common cause of a falsely elevated potassium
  • Hypokalemia is often caused by GI losses, diuretics, or inadequate intake
    • ECG changes: U waves, flattened T waves, ST depression
    • Replace both potassium and magnesium (hypomagnesemia impairs K repletion)
  • Hyperkalemia is a life-threatening emergency when >6.5 mEq/L or with ECG changes
    • ECG progression: peaked T waves, widened QRS, sine wave, asystole
    • Treat with calcium (membrane stabilization), insulin + glucose (intracellular shift), and elimination (kayexalate, dialysis)[1]

See Also

References

  1. Palmer BF. Managing hyperkalemia caused by inhibitors of the renin-angiotensin-aldosterone system. N Engl J Med. 2004; 351(6):585-592. PMID 15295051.