Hypokalemia: what is it, symptoms

Potassium ions are necessary for normal functioning of every cell and organism as a whole. When there is a lack in the blood, which in medicine is called «hypokalemia», disrupted the normal balance of ions between the intracellular and extracellular space. In addition, potassium plays an important role in the excitation of nerve cells and conduct nerve impulses, in critical situations, potassium ions held constant as the internal environment (homeostasis). All this indicates the great importance of these ions to humans. This is worth remembering when trying to lose weight by means of exhausting hunger strikes or the abuse of diuretics to combat fluid retention.

Hypokalemia. What it is and its causes

Hypokalemia is called the content of potassium ions in the serum of less than 3.5 mmol/L. normal this figure should be 3.5 – 5.5 mmol/l. Interesting fact is that 98% of these ions is contained inside the cells and only 2% of normal in the serum. The reasons for reducing the amount of potassium in the blood include:

  • An insufficient supply of ions from outside the body with food. This can happen during prolonged starvation or when eating food, which is poor in potassium.
  • Decrease of potassium from the digestive tract after the removal of part of the stomach or intestines.
  • Insufficient intake of potassium with food as a result of prolonged parenteral nutrition, the poor on these ions.
  • Increased loss of potassium ions vomit with vomiting or with stool in diarrhea.
  • Large losses of potassium in the urine, when the frequency or volume of urination higher than normal. This can happen when hyperaldosteronism (adrenal disease), congestive heart failure, occurring with polyuria, kidney diseases (nephritis, nephrotic syndrome) or diseases of the liver, proceeding with ascites (fluid accumulation in the abdominal cavity).
  • Metabolic alkalosis – change in acid-base balance in the body due to excess of alkali.
  • Diabetic coma and the dose of insulin that exceeds the norm.
  • The use of certain drugs (diuretics, laxatives, beta-agonists, hormonal drugs, vitamin B12, transfusion of thawed red blood cells).
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Symptoms of hypokalemia

Manifestations of the low content of potassium ions in the body will depend on the severity of the condition. The first signs of hypokalemia will occur when potassium in the blood is less than 3.0 mmol/L. these include weakness, lethargy, fatigue, drowsiness and decreased disability. Later joined by bradycardia (slow pulse), spasms in the gastrocnemius and other muscles, weakness in legs, tremor in the limbs and throughout the body. The initial manifestations can also be attributed to the increase in the volume of urine excreted per day (polyuria). Manifestations of more severe losses of potassium include:

  • Paresis and paralysis of the limb muscles, diaphragm (the slowing or stopping of breathing), gastrointestinal (atony and ileus).
  • Changes of the heart and blood vessels and reduction in blood pressure (hypotension). On ECG there will be noticeable signs of myocardial ischemia due to the reduction of potassium – low T wave, the lowering of the ST segment below the isoline, the expansion and elongation of QRS PQ. If hypokalemia develops in a patient with existing myocardial ischemia or increased left ventricle, can cause severe cardiac arrhythmia (the occurrence of extrasystoles, atrial fibrillation).
  • Mental disorders in form of depression.
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    Diagnosis of hypokalemia

    Before treating any disease you must find out the cause. If the level of potassium in the blood is less than 3.5 mmol/l, then carry out the following activities:

    • History collection. We need to find out whether the patient takes drugs that reduce potassium in the blood. Does he have uncontrollable vomiting or diarrhea, he may artificially cause vomiting (e.g., anorexia).
    • The study of the function of the kidneys to eliminate causes from the urinary system. To do this, hold the urine test for potassium. Normally it should be 15 – 25 mmol/L.
    • Determination of the level of bicarbonate in the blood serum to eliminate alkalosis as a cause of hypokalemia.
    • Determination of the level of renin to exclude tumor formation in the kidneys.
    • Determination of aldosterone level in order to avoid disease of the adrenal glands.
    • EKG – if true hypokalemia will occur with signs of infringement of processes of repolarization and hypoxia (oxygen starvation) of the myocardium.
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    Treatment of potassium deficiency in the body

    Therapeutic measures will depend on the reasons that led to the loss of potassium:

  • Diet prescribed to patients who have the cause of hypokalemia – lack of potassium in food. Recommended eating more foods rich in potassium. These include: honey; dried fruits (apricots, raisins); cereals (buckwheat, oat, wheat); legumes (peas, soybeans, beans); vegetables (tomatoes, potatoes, cabbage); fresh juices (carrot, orange); nuts (almonds, pine); sea cabbage; sea fish.
  • Oral application of preformed potassium (Asparcam, Panangin). These drugs are often used in hypokalemia caused by the use of large doses of diuretics. They can be used to prevent loss of potassium in the treatment of diuretics.
  • For the treatment of metabolic alkalosis used intravenous potassium chloride. Given the fact that the slightest error in calculating the dose of the drug can lead to reverse increase of potassium in the body and related complications, such treatment is carried out strictly in the hospital. Any introduction of potassium is carried out under close monitoring of ECG and the amount of potassium in the blood serum.