Chapter 046. Sodium and Water (Part 12) potx

Vitamin B12 or folic acid red blood cell production 2.. Granulocyte-macrophage colony stimulating factor white blood cell production 3.. Increased distal flow: diuretics, osmotic... Incr

Chapter 046 Sodium and Water

(Part 12)

Table 46-3 Causes of Hypokalemia

I Decreased intake

A Starvation

B Clay ingestion

II Redistribution into cells

A Acid-base

1 Metabolic alkalosis

B Hormonal

1 Insulin

2 β2-Adrenergic agonists (endogenous or exogenous)

3 α-Adrenergic antagonists

C Anabolic state

1 Vitamin B12 or folic acid (red blood cell production)

2 Granulocyte-macrophage colony stimulating factor (white blood cell production)

3 Total parenteral nutrition

D Other

1 Pseudohypokalemia

2 Hypothermia

3 Hypokalemic periodic paralysis

4 Barium toxicity

III Increased loss

A Nonrenal

1 Gastrointestinal loss (diarrhea)

2 Integumentary loss (sweat)

B Renal

1 Increased distal flow: diuretics, osmotic

diuresis, salt-wasting nephropathies

2 Increased secretion of potassium

a Mineralocorticoid excess: primary hyperaldosteronism, secondary hyperaldosteronism (malignant hypertension, renin-secreting tumors, renal artery stenosis, hypovolemia), apparent mineralocorticoid excess (licorice, chewing tobacco, carbenoxolone), congenital adrenal hyperplasia, Cushing's syndrome, Bartter's syndrome

b Distal delivery of non-reabsorbed anions: vomiting, nasogastric suction, proximal (type 2) renal tubular acidosis, diabetic ketoacidosis, glue-sniffing (toluene abuse), penicillin derivatives

c Other: amphotericin B, Liddle's syndrome, hypomagnesemia