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Life-threatening hypokalemia in hospitalized patients
J Halevy1, M Gunsherowitz, J B Rosenfeld
1Department of Internal Medicine E, Beilinson Medical Center, Petah Tiqva, Israel.
Insights
Severe hypokalemia, a dangerous drop in serum potassium, often arises from hospital treatments. Prevention involves diligent serum potassium monitoring and proper potassium supplementation to avoid iatrogenic causes.
Area of Science:
- Internal Medicine
- Clinical Biochemistry
Background:
- Severe hypokalemia (serum potassium ≤ 2.5 mmol/l) is a critical electrolyte imbalance.
- This condition affects a small but significant percentage of hospitalized patients.
Purpose of the Study:
- To investigate the incidence, causes, and patient demographics of severe hypokalemia in a major Israeli university hospital.
- To identify key factors contributing to severe hypokalemia in hospitalized individuals.
Main Methods:
- Retrospective analysis of serum biochemical profiles over 13 years.
- Identification and categorization of causes for severe hypokalemia in affected patients.
Main Results:
- Severe hypokalemia occurred in 0.03% of profiles (130 patients).
- Iatrogenic factors (IV fluids, K-depleting drugs, insulin) caused 68% of cases; gastrointestinal losses accounted for 22%.
- The majority of affected patients were female (65%) with a mean age of 64 years.
Conclusions:
- Severe hypokalemia in hospitalized patients is frequently multifactorial and iatrogenic.
- Effective prevention strategies include regular serum potassium monitoring and adequate potassium replacement therapy.
Abstract:
Severe life-threatening hypokalemia (serum potassium less than or equal to 2.5 mmol/l) was found in 0.03% of serum biochemical profiles within 13 years in a major university hospital in Israel. Out of 130 patients with hypokalemia of this magnitude, 84 (65%) were females and the mean age was 64 years. A combination of iatrogenic factors, including the administration of intravenous fluids with insufficient or no potassium (K) replacement and the use of K-depleting medications and insulin, was responsible for the hypokalemia in 68% of the patients. Gastrointestinal loss of K was the main cause of severe hypokalemia in 22% of the patients. It is concluded that severe hypokalemia in hospitalized patients is commonly the result of multiple iatrogenic factors and, therefore, can be prevented by frequent monitoring of serum K and appropriate K supplementation.