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Endocrinology

Hypopotassemia - the Hyperpotassemia and a hypopotassemia

Table of contents
Hyperpotassemia and hypopotassemia
Anamnesis of a hyperpotassemia
Diagnostic approach at a hyperpotassemia
Renal canalicular acidosis with a hyperpotassemia and a hypopotassemia
Hypopotassemia
Diagnostic approach at a hypopotassemia

At a hypopotassemia serumal potassium concentration is lower than 3 mmol/l. Decrease in serumal potassium concentration; can be a consequence of deficit of the general maintenance of this ion in an organism or just to be result of transition of potassium to intracellular space. The major factors and syndromes connected with a hypopotassemia are provided to table.

Clinical states at which the hypopotassemia most often meets


Syndrome

Clinical and laboratory signs

The diagnostic methods which are subject to a first-priority assessment

Treatment  by diuretics

Dizziness,
orthostatic
  pulse rate  and
arterial
pressure)

Anamnesis; arterial pressure, hematocrit indicator, content in blood serum of uric acid, urea nitrogen, bicarbonate

Primary aldosteronism

Arterial hypertension, metabolic alkalosis

Anamnesis; research of an eyeground (pathological changes usually are absent), the content in blood serum and in urine K, a renin and Aldosteronum

Reinsekretiruyushchy tumors

Arterial hypertension, metabolic alkalosis

Anamnesis; signs and symptoms; content in urine K, a renin, serumal concentration of Aldosteronum, the maintenance of a renin in the blood taken from renal veins; angiography of renal arteries

Renal canalicular acidosis

Lag in development  in children, a polyuria (disturbance  of concentration  ability of kidneys), nephroliths, a nephrocalcinosis, acidosis

Anamnesis; content of potassium in blood serum and in urine, the analysis of gas composition of blood, definition rn urine against acidosis in blood test, the maintenance of Aldosteronum in urine

Barter syndrome

Occurs at children; disturbances of intellectual and physical times weaknesses, paresthesias, polyuria; normal ABP

The anamnesis (the hidden use of diuretics?); ABP, content in blood of a renin, Aldosteronum, research of gas composition of blood, content of electrolytes in urine

Liddl's syndrome
Vomiting  or  suction   of gastric   contents

Arterial hypertension
Metabolic alkalosis

Anamnesis (family); concentration To in blood serum, gas structure of an arterial blood, the maintenance of a renin in blood, the maintenance of Aldosteronum in blood serum and in urine
Anamnesis; the main structure of an arterial blood, serumal concentration To. content in Na urine, O, K, rn urine

 

Anamnesis

Clinically the hypopotassemia is usually shown by muscular weakness, easy fatigue, decrease in concentration ability of kidneys and a polyuria, and also orthostatic arterial hypotension without developing of compensatory tachycardia. At heavy insufficiency of potassium can arise a holoplexia of muscles and rabdomioliz. Development of these symptoms is usually connected with falling of serumal potassium concentration lower than 2 mmol/l. It is extremely important to collect as much as possible information on a clinical situation at which there is a hypopotassemia.

Physical inspection

Many syndromes listed in the tab. can be shown by the specific and characteristic clinical signs revealed at physical inspection. In most cases, except for the Barter syndrome, a characteristic symptom is arterial hypertension. Arterial hypertension can be combined with vomiting or arise against treatment by diuretics, however it is optional. Gipokaliyemichesky periodic paralysis, seldom found disease, unmistakably determine by existence of muscular weakness and sluggish paralysis. The disturbances of concentration function of kidneys which are shown a polyuria are a characteristic sign of a nephropathy with exhaustion of reserves of potassium; these clinical signs it is usual confirm the expressed deficit of potassium.



 
Hypercalcemia"