Hypokalemia: a clinical update

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Hypokalemia is a common electrolyte disturbance, especially in hospitalized patients. It can have various causes, including endocrine ones. Sometimes, hypokalemia requires urgent medical attention. The aim of this review is to present updated information regarding: (1) the definition and prevalence of hypokalemia, (2) the physiology of potassium homeostasis, (3) the various causes leading to hypokalemia, (4) the diagnostic steps for the assessment of hypokalemia and (5) the appropriate treatment of hypokalemia depending on the cause. Practical algorithms for the optimal diagnostic, treatment and follow-up strategy are presented, while an individualized approach is emphasized.

Related collections

Most cited references 47

Record: found
Abstract: found
Article: not found

The Management of Primary Aldosteronism: Case Detection, Diagnosis, and Treatment: An Endocrine Society Clinical Practice Guideline.

John Funder, Robert Carey, Franco Mantero … (2016)

To develop clinical practice guidelines for the management of patients with primary aldosteronism.

0 comments Cited 905 times – based on 0 reviews      Review now

Record: found
Abstract: found
Article: not found

Renin-angiotensin-aldosterone (RAAS): The ubiquitous system for homeostasis and pathologies.

Tareq Abu-Izneid, Haroon Khan, Abdur Rauf … (2017)

Renin-angiotensin-aldosterone system (RAAS) is a vital system of human body, as it maintains plasma sodium concentration, arterial blood pressure and extracellular volume. Kidney-secreted renin enzyme acts on its substrate to form angiotensin II, a versatile effector peptide hormone. Every organ is affected by RAAS activation and the resultant hypertension, cell proliferation, inflammation, and fibrosis. The imbalance of renin and angiotensin II can result in an overwhelming number of chronic and acute diseases. RAAS is influenced by other enzymes, hormones, pumps and signaling pathways, hence, this review discusses important facets of this system, its crosstalk with other crucial factors like estrogen, thyroid, cortisol, kallikrein-kinin system, Wnt/β-catenin signaling, and sodium-potassium pump. The nexus of RAAS with the above-discussed systems was scantily explored before. So, this review furnishes a new perspective in comprehension of inflammation diseases. It is followed by the formulation of hypotheses, which can contribute to better management of an array of pathologies plaguing mankind. Manipulation of RAAS, by bending it towards ACE2 expression can regulate endocrine functions, which can be critical for a number of pathological management. Dietary intervention can restore RAAS to normalcy.

0 comments Cited 221 times – based on 0 reviews      Review now

Record: found
Abstract: found
Article: not found

Potassium homeostasis and renin-angiotensin-aldosterone system inhibitors.

Mark Rolfe, Jacquelyn Weir (2010)

Inhibition of the renin-angiotensin-aldosterone system (RAAS) is a key strategy in treating hypertension and cardiovascular and renal diseases. However, RAAS inhibitors (angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, aldosterone receptor antagonists, and direct renin inhibitors) increase the risk of hyperkalemia (serum potassium >5.5 mmol/L). This review evaluates the effects on serum potassium levels of RAAS inhibitors. Using PubMed, we searched for clinical trials published up to December 2008 assessing the effects on serum potassium levels of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, aldosterone receptor antagonists, and direct renin inhibitors, alone and in combination, in patients with hypertension, heart failure (HF), or chronic kidney disease (CKD); 39 studies were identified. In patients with hypertension without risk factors for hyperkalemia, the incidence of hyperkalemia with RAAS inhibitor monotherapy is low (< or =2%), whereas rates are higher with dual RAAS inhibition ( approximately 5%). The incidence of hyperkalemia is also increased in patients with HF or CKD (5% to 10%). However, increases in serum potassium levels are small ( approximately 0.1 to 0.3 mmol/L), and rates of study discontinuation due to hyperkalemia are low, even in high-risk patient groups (1% to 5%). Patients with HF or CKD are at greater risk of hyperkalemia with RAAS inhibitors than those without these conditions. However, the absolute changes in serum potassium are generally small and unlikely to be clinically significant. Moreover, these patients are likely to derive benefit from RAAS inhibition. Rather than denying them an effective treatment, electrolyte levels should be closely monitored in these patients.

0 comments Cited 89 times – based on 0 reviews      Review now

All references

Author and article information

Journal

Journal ID (nlm-ta): Endocr Connect

Journal ID (iso-abbrev): Endocr Connect

Journal ID (hwp): EC

Title: Endocrine Connections

Publisher: Bioscientifica Ltd (Bristol )

ISSN (Electronic): 2049-3614

Publication date Collection: April 2018

Publication date (Electronic): 14 March 2018

Volume: 7

Issue: 4

Pages: R135-R146

Affiliations

[1 ]Department of Endocrinology and Diabetes Evangelismos Hospital, Athens, Greece

[2 ]Division of Endocrinology and Diabetes ‘Aghia Sophia’ Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece

[3 ]Unit of Reproductive Endocrinology First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece

[4 ]Division of Endocrinology Department of Clinical Medicine and Surgery, ‘Federico II’ University of Naples, Naples, Italy

[5 ]First Department of Cardiology Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece

[6 ]Department of Endocrinology and Diabetes Hellenic Red Cross Hospital, Athens, Greece

Author notes

Correspondence should be addressed to A Vryonidou: mahi_vr@ 123456hotmail.com

Article

Publisher ID: EC180109

DOI: 10.1530/EC-18-0109

PMC ID: 5881435

PubMed ID: 29540487

SO-VID: c5f5687a-1b5e-40e2-8062-b64ed2245159

License:

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

The flagship journal of the Society for Endocrinology. Learn more

Hypokalemia: a clinical update

Read this article at

Abstract

Related collections

Bioscientifica Open Endocrinology

Most cited references 47

The Management of Primary Aldosteronism: Case Detection, Diagnosis, and Treatment: An Endocrine Society Clinical Practice Guideline.

Renin-angiotensin-aldosterone (RAAS): The ubiquitous system for homeostasis and pathologies.

Potassium homeostasis and renin-angiotensin-aldosterone system inhibitors.

Author and article information

Journal

Affiliations

Author notes

Article

History

Categories

Comments

Comment on this article

Similar content 240

Cited by 105

Most referenced authors 501