What is Hypokalemia?

symptom of hypokalemia

What is Hypokalemia?

Hypokalemia is when potassium levels in the bloodstream are below normal limits. Under normal conditions, potassium levels in the blood range from 3.6 to 5.2 millimolar per liter (mmol / L). However, if potassium levels are deficient, for example, less than 2.5 mmol / L, it can be dangerous or even cause death if not treated immediately.

Potassium is an electrolyte essential for nerve and muscle function, especially the heart muscle.

Potassium also acts as a regulator of blood pressure. Potassium levels in the body are controlled by the kidneys.

If potassium levels are excessive, the kidneys will eliminate potassium from the body through sweat or urine. Potassium levels in the body also depend on sodium and magnesium levels. 

Excess sodium in the body will increase the body's need for potassium, while magnesium deficiency is often accompanied by hypokalemia.

People who experience eating disorders (such as anorexia nervosa and bulimia), alcoholics, or AIDS sufferers are more at risk of developing potassium deficiency.

Potassium deficiency can also increase the risk of complications, such as muscle weakness, arrhythmias, and other heart problems.

Symptoms of Hypokalemia

Some symptoms can occur if potassium levels are below average, including:

• Stomach cramps and constipation.
• Tingling and numbness.
• Nausea, bloating and vomiting.
• Palpitations or palpitations.
• Faint when low blood pressure.
• Frequent urination and feeling thirsty.
• Fatigue and cramps in the arms and legs muscles.
• Psychological disorders, such as depression, delirium, confusion, or hallucinations.

If the potassium level in the blood is less than 2.5 mmol / L, this condition can be classified as severe hypokalemia that can be life-threatening.

Some symptoms of severe hypokalemia that can occur in sufferers are:

• Paralysis.
• Respiratory failure.
• Damage to muscle tissue.
• There is no movement of the digestive tract.

In someone with hypokalemia who also consumes digitalis drugs (such as digoxin), arrhythmia symptoms can occur in the form of tachycardia, bradycardia, or atrial and ventricular fibrillation. In addition, symptoms such as loss of appetite, nausea, and vomiting can also occur.

Causes of Hypokalemia

Potassium deficiency can be caused by several things. Still, the most frequent factor causing excessive potassium loss is the use of diuretic drugs that accelerate the formation of urine.

Several other factors can cause potassium deficiency, including chronic kidney failure, diarrhea, diabetic ketoacidosis, excessive use of laxatives and alcohol, excessive sweating, folic acid deficiency, and some use of certain antibiotic drugs.

While some diseases and other conditions that can also cause hypokalemia are:

• Bartter's syndrome (genetic disease of the kidneys that causes an imbalance of mineral salts, including potassium in the body).
• Gitelman Syndrome (a genetic disease in the kidneys that causes ion imbalance in the body).
• Liddle's syndrome (a genetic disease that can cause an increase in blood pressure and hypokalemia).
• Cushing's syndrome (a chronic disease that arises due to the long-term effect of the hormone cortisol in the body).
• Familial hypokalemia.
• Eat certain foods that contain bentonite and glycyrrhizin compounds.
• Diuretic drugs, especially diuretics, can remove potassium from the body, for example, the thiazide group.
• Magnesium deficiency.
• Malnutrition.
• Potassium absorption disorders.
• Hyperthyroidism
• Renal tubular acidosis types 1 and 2.
• Barium poisoning.

Hypokalemia diagnosis

To determine whether someone has hypokalemia or not, the following diagnostic steps are:

Blood test.

This diagnostic step is used to measure potassium levels in the blood. Doctors will usually ask you not to take drugs that can affect the test results.

Normal potassium levels in the blood are 3.6-5.2 mmol / L. Hypokalemia certainly occurs in your body if the potassium level is less than this.

Urine test.

This diagnostic step is usually done to determine the path of the highest potassium removal in someone with hypokalemia.

Urine will be taken to measure potassium levels to see how much potassium in the blood is excreted through urine.

If the potassium level in the urine is more than 40 mmol / L, potassium is removed through urine in large quantities.

If the potassium level in the urine is less than 20 mmol / L, your potassium may be removed from the digestive tract in large quantities.

In addition, with urine potassium levels less than 20 mmol / L, potassium intake is less than enough, or there is a high intracellular potassium absorption.

To ensure that someone needs to be asked about diarrhea, use of laxatives, insulin, and bicarbonate supplements.

Electrocardiogram (ECG).

The purpose of diagnosing hypokalemia using the ECG method is to determine whether hypokalemia affects cardiac performance, especially in someone with hypokalemia who also has heart problems.

Treating Hypokalemia

Treatment for someone with hypokalemia varies depending on the symptom type. Broadly speaking, potassium deficiency can be treated with three stages consisting of:

1. Treat the cause of potassium deficiency

After diagnosing and finding out the cause of potassium deficiency, the doctor will treat the underlying condition of potassium deficiency.

For example, your doctor will give you medication to treat diarrhea and vomiting if both of these are the cause of potassium deficiency.

Meanwhile, if a lot of potassium is wasted in the urine, then some types of drugs that might be prescribed are:

• Angiotensin-converting enzyme inhibitors. This group of drugs prevents potassium loss in the blood through urine by inhibiting aldosterone production in the kidneys. Side effects often arise from its use are coughing, fatigue, dry mouth, impotence, and dizziness, especially if taken with antihypertensive drugs. Some examples of drugs that enter the angiotensin-converting enzyme inhibitors are captopril, enalapril, fosinopril, and ramipril.
• Angiotensin II receptor blockers (angiotensin receptor blockers). This group of drugs prevents potassium loss through urine by inhibiting angiotensin II, thereby reducing the secretion of aldosterone hormone in the kidneys. Examples of drugs from this group are valsartan, candesartan, and losartan.
• Potassium-saving diuretic group. This group of drugs can still function as a diuretic but does not cause the release of potassium through urine. Examples of drugs from this group are triamterene and amiloride.
• Aldosterone selective antagonists. This group of drugs can selectively inhibit the binding of aldosterone to mineralocorticoid receptors so it can be used as a potassium-sparing diuretic drug. Examples of drugs from this group are spironolactone and eplerenone.

2. Returns potassium levels. 

The doctor will prescribe an oral potassium supplement if your condition is not too severe. However, the supplement will be given intravenously if your need is serious.

Using potassium supplements can have side effects such as stomach irritation and vomiting. In addition, potassium supplements given by infusion must be channeled slowly to avoid the possibility of heart problems. 

Potassium supplements are generally potassium chloride (KCl) which is available in various forms of oral or intravenous fluids.

Someone with hypokalemia who also suffers from calcium stones in the body or suffers from severe acidosis can consume potassium citrate instead of potassium chloride.

3. Monitor potassium levels. 

During the treatment period, the doctor will monitor potassium levels in your body to ensure that your condition remains normal.

This step is done to prevent the intake of potassium supplements is not excessive. Because potassium levels that are too high will cause quite serious complications.

Recommend a healthy diet high in potassium. Before you leave the hospital, you will be given instructions to adjust your diet so that potassium intake is maintained.

In addition, the doctor will also regulate a diet high in magnesium which is often associated with potassium, including recommending magnesium supplements.

After leaving the hospital, the doctor will usually recommend consuming potassium foods. If needed, your doctor will prescribe potassium and magnesium supplements. Because magnesium deficiency can trigger a potassium deficiency.

Prevent Hypokalemia

Potassium deficiency can be avoided by keeping potassium levels in the blood under normal conditions. Several foods can be consumed to keep potassium levels normal, including avocado, fig fruit, banana, orange, kiwi, tomato, spinach, nuts, wheat, peanut butter, and milk.

Certain medications can also cause someone to experience potassium deficiency. Therefore, avoid overuse of diuretic drugs to reduce the risk of this condition, and it is recommended to always consult your doctor to get the most suitable treatment.

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