Potassium (K+ )

Hypokalemia and Hyperkalemia

Potassium (K+ )

Potassium is a mineral that your body needs to work properly. It is a type of electrolyte. It helps your nerves to function and muscles to contract. It helps your heartbeat stay regular. It also helps move nutrients into cells and waste products out of cells. A diet rich in potassium helps to offset some of sodium’s harmful effects on blood pressure.

Potassium is the most abundant intracellular cation. 98% of potassium is found intracellular with ¾ of the total body potassium in skeletal muscles. The average daily requirement is 1 mmol/kg.


Potassium is an electrolyte that the body needs to stay healthy. As the American Heart Association (AHA) note, foods that contain potassium can help manage blood pressure by reducing the negative impact of sodium.

Having high sodium levels can increase the risk of high blood pressure. In healthy people, potassium lowers this risk by helping the body remove sodium. It also helps manage blood pressure by relaxing the walls of the blood vessels.

Reduction of Stroke

According to the Centers for Disease Control, stroke is the fifth leading cause of death in the United States and is a major cause of serious disability in adults. You can lower your chances or prevent the risk of stroke by taking various actions.

Treatment of Hypertension

High blood pressure can make the heart work too hard and increases the risk of heart disease as well as other health conditions such as stroke, congestive heart failure, kidney disease, and blindness. In an older but very memorable clinical trial, Dietary Approaches to Reduce Hypertension (DASH) published in the New England Journal of Medicine, researchers determined that a diet rich in fruits, vegetables, and low-fat dairy foods, and with reduced saturated and total fat can substantially lower blood pressure.

Kidney health

In healthy individuals, low potassium levels may inhibit the kidneys’ ability to reabsorb calcium. High calcium levels in the kidneys can result in kidney stones.

Research from 2015 Trusted Source notes that switching to the DASH diet may help reduce the risk of kidney stones, as the diet favors foods that are rich in potassium and other essential nutrients.

However, people with kidney failure should not consume too much potassium, as it could have a negative impact. In this case, a doctor will recommend how much potassium to include in the diet.

Prevention of Muscle Cramping

Extensive exercise does require replacement of electrolytes, both potassium and sodium because they are lost through sweat. However, for the prevention of muscle cramping, adequate amounts of potassium and sodium before, during, and after exercise seem to be most important.

Sources of potassium

The most common source of potassium is from food. Potassium-rich sources include:

  • fruits, such as apricots, bananas, kiwi, oranges, and pineapples
  • vegetables, such as leafy greens, carrots, and potatoes
  • lean meats
  • whole grains
  • beans and nuts

Most people get enough potassium by eating a balanced diet. For low potassium levels, a doctor may prescribe the mineral in supplement form. If you have a severe deficiency, you may need intravenous (IV) treatment.

Potassium depletion (Hypokalemia) K + less than 3.5 millimol

Low potassium (hypokalemia) refers to a lower than normal potassium level in your bloodstream. Potassium helps carry electrical signals to cells in your body. It is critical to the proper functioning of nerve and muscles cells, particularly heart muscle cells.

Most patients are asymptomatic. Clinical symptoms and signs such as listlessness, slurred speech, muscular hypotonia, and depressed reflexes are presenting features. Abdominal distention results due to paralytic ileus.


Low potassium (hypokalemia) has many causes. The most common cause is excessive potassium loss in urine due to prescription medications that increase urination. Also known as water pills or diuretics, these types of medications are often prescribed for people who have high blood pressure or heart disease.

Vomiting, diarrhea or both also can result in excessive potassium loss from the digestive tract. Occasionally, low potassium is caused by not getting enough potassium in your diet.

Causes of potassium loss include:

  1. Alcohol use (excessive)
  2. Chronic kidney disease
  3. Diabetic ketoacidosis
  4. Diarrhea
  5. Diuretics (water retention relievers)
  6. Excessive laxative use
  7. Excessive sweating
  8. Folic acid deficiency
  9. Primary aldosteronism
  10. Some antibiotic use
  11. Vomiting


  • Oral potassium in the form of milk, meat extracts, fruit juices, honey and KCl tablets
  • 40 mmol KCl IV added to 1 liter of fluid run over 6 -8 hours. Never directly IV.
  • Correct the underlying cause

N.B.:- Administration should be properly controlled, the level of potassium should be checked daily and the urine out put must be adequate.

Potassium Excess (Hyperkalemia) K+ more than 5 mmol.

Significant quantity of intracellular potassium is released into the extra cellular space in response to severe injury, surgery, acidosis and a catabolic state. A significant rise in serum potassium concentration may occur in these states in the presence of oliguric or anuric renal failure. A renal insufficiency with hypoaldosteronism can cause hyperkalemia.

Nausea, vomiting, intermittent intestinal colic and diarrhea are the presenting pictures. Cardiovascular signs are apparent on ECG with high peaked T waves, widened QRS complex and depressed ST segment. Disappearance of T waves, heart block and cardiac arrest may develop with increasing levels of potassium.


Measures to reduce K+ level:

  • Administration of bicarbonate and glucose with insulin. 10 to 20 units of regular insulin and 25 to 50 g of glucose can be used.
  • 10 ml of 10% calcium gluconate to suppress the myocardial effect
  • Enteral administration of cation exchange resign (Kayexalate).
  • Dialysis
  • Avoid exogenous potassium

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