Potassium Disorders: Hypokalemia and Hyperkalemia.

Area of Science:

• Nephrology
• Internal Medicine
• Cardiology

Background:

• Hypokalemia (serum potassium < 3.5 mEq/L) and hyperkalemia (serum potassium > 5.0 mEq/L) are common electrolyte disturbances.
• Optimal cardiovascular health necessitates adequate daily potassium intake (WHO: ≥ 3,510 mg/day).
• Both conditions arise from various factors including intake, excretion, and cellular shifts.

Purpose of the Study:

• To review the causes, diagnosis, and management of hypokalemia and hyperkalemia.
• To highlight urgent treatment criteria and long-term management strategies for potassium disturbances.

Main Methods:

• Literature review of hypokalemia and hyperkalemia causes, diagnosis, and treatment.
• Discussion of diagnostic tools like electrocardiography and serum potassium levels.
• Overview of acute and chronic management strategies, including medications and dialysis.

Main Results:

• Severe hypokalemia (< 2.5 mEq/L) with ECG or neuromuscular symptoms requires urgent treatment.
• Hyperkalemia management involves emergent treatment for symptomatic or ECG-abnormal patients.
• Newer potassium binders (patiromer, sodium zirconium cyclosilicate) offer alternatives to older agents with significant side effects.

Conclusions:

• Effective management of potassium disturbances involves addressing root causes, appropriate replenishment or removal, and long-term strategies.
• Timely intervention based on severity and symptoms is crucial for preventing complications.
• Dietary counseling and medication review are essential components of long-term potassium balance.