What is Hypokalemia?
What is Hypokalemia? Hypokalemia is a condition when potassium levels in the bloodstream fall below normal limits. Under normal conditions, potassium levels in the blood range from 3.6 to 5.2 millimolar per liter (mmol / L). However, if potassium levels are very low, ie less than 2.5 mmol / L, then it can be harmful or even cause death if not treated immediately.
Potassium is a very important electrolyte for nerve and muscle function, especially the heart muscle. Potassium also acts as a blood pressure regulator. Potassium levels in the body are controlled by the kidneys. If the levels of potassium are excessive, the kidneys will remove potassium from the body through sweat or through the urine. Levels of potassium in the body also depends on sodium and magnesium levels. Excess sodium in the body will increase the body’s need for potassium, while magnesium deficiency is often accompanied by hypokalemia.
People with eating disorders (eg anorexia nervosa and bulimia), alcoholics, or people with AIDS are at greater risk of potassium deficiency. Potassium deficiency can also increase the risk of complications, such as muscle weakness, arrhythmia, and some other heart problems.
Symptoms of Hypokalemia
There are several symptoms that can arise if potassium levels are below normal limits, among others:
- Abdominal cramps and constipation.
- Tingling and numbness.
- Nausea, bloating, and vomiting.
- Palpitations or palpitations.
- Fainting when blood pressure is low.
- Frequent urination and feel thirsty.
- Fatigue, as well as cramps in the muscles of the arms and legs.
- Psychological disorders, such as depression, delirium, confusion, or hallucinations.
If the potassium level in the blood is less than 2.5 mmol / L, then this condition can be classified as severe hypokalemia that can be life-threatening. Some of the symptoms of severe hypokalemia that can appear in the sufferer are:
- Paralysis or paralysis.
- Respiratory failure.
- Damage to muscle tissue.
- There is no movement of the gastrointestinal tract.
In patients with hypokalemia who also take the drug digitalis class (eg digoxin), can appear symptoms of arrhythmias in the form of tachycardia, bradycardia, or atrial and ventricular fibrillation. In addition, symptoms such as loss of appetite, nausea, and vomiting can also occur.
Causes of Hypokalemia
Potassium deficiency can be caused by several things, but the factor that is most often the cause of excessive loss of potassium is the use of diuretic drugs that serve to accelerate the formation of urine.
There are several other factors that can lead to potassium deficiency, among which are chronic renal failure, diarrhea, diabetic ketoacidosis, excessive use of laxatives and alcohol, too much sweating, lack of folic acid, and some use of certain antibiotics.
While some diseases and other conditions that can also cause hypokalemia are:
- Bartter’s syndrome (a genetic disease in the kidneys that causes mineral salt imbalances, including potassium in the body).
- Gitelaman syndrome (genetic disease of the kidneys that causes imbalance of ions in the body).
- Liddle’s syndrome (a genetic disease that can cause an increase in blood pressure and also hypokalemia).
- Cushing’s syndrome (a chronic illness arising from the effects of hormone cortisol on the body in the long run).
- Familial hypokalemia.
- Eat certain foods containing bentonite and glycyrrhizin compounds.
- Diuretic drugs, especially diuretics that can remove potassium from the body, for example is thiazide group.
- Magnesium deficiency.
- Impaired potassium absorption.
- Renal tubular acidosis type 1 and 2.
- Barium poisoning.
Diagnosis of Hypokalemia
To ascertain whether a patient has hypokalemia or not, the necessary diagnostic steps are:
- Blood test. This diagnostic step is used to measure potassium levels in the blood. The doctor will usually ask the patient not to take any medication that may affect the test results. Normal potassium levels in the blood is 3.6-5.2 mmol / L. If the potassium level is less than that number, it can be ascertained that there is hypokalemia in the patient.
- Urine test. This step of diagnosis is usually performed to determine the highest potassium disposal pathway in hypokalemia patients. The patient’s urine will be taken for measured potassium levels so that it can be known how much potassium in the blood is dumped through the urine. If potassium levels in the urine are more than 40 mmol / L, it means that potassium exhaust through the urine in large quantities. If potassium levels in the urine are less than 20 mmol / L, potassium from patients may be discharged through the digestive tract in large quantities. In addition, with urinary potassium levels of less than 20 mmol / L, the patient’s intake of potassium is less than adequate or high intracellular potassium absorption is occurring. To be sure the patient needs to be asked about diarrhea, use of laxatives, insulin use, and bicarbonate supplements.
- Electrocardiogram (EKG). The purpose of diagnosis of hypokalemia using EKG method is to determine whether there is an effect of hypokalemia on cardiac performance, especially in patients with hypokalemia who also have heart problems.
Treatment in patients with hypokalemia varies, depending on the type of symptoms that develop. Broadly speaking, potassium deficiency can be treated with three stages consisting of:
Treating the causes of potassium deficiency. After making a diagnosis and finding the cause of potassium deficiency, the doctor will treat the condition underlying the occurrence of potassium deficiency. For example, doctors will administer medicines to treat diarrhea and vomiting if they are the cause of potassium deficiency. Meanwhile, if much potassium is wasted through the urine, then some types of drugs that may be prescribed are:
- Angiotensin converting enzyme inhibitors (angiotensin converting enzyme inhibitors). This group of drugs serves to prevent the loss of potassium in the blood through the urine by inhibiting the production of aldosterone in the kidney. Side effects that often arise from their use are coughing, fatigue, dry mouth, impotence and dizziness, especially if taken in conjunction with antihypertensive drugs. Some examples of drugs that fall into the angiotensin-converting enzyme class are captopril, enalapril, fosinopril, and ramipril.
- Angiotensin II receptor blockers (angiotensin receptor blockers). This group of drugs serves to prevent potassium loss through urine by inhibiting angiotensin II thereby reducing the secretion of aldosterone hormone in the kidney. Examples of drugs of this class are valsartan, candesartan, and losartan.
- Potassium-sparing diuretic groups. This group of drugs may continue to function as diuretics, but does not result in potassium excretion through the urine. Examples of drugs of this class are triamterene and amiloride.
- Selective aldosterone antagonist groups. This group of drugs can inhibit the binding of aldosterone to selective mineralocorticoid receptors, so that it can be used as a potassium-sparing diuretic. Examples of drugs of this class are spironolactone and eplerenone.
Restores potassium levels. If the patient’s condition is not too severe, the doctor will prescribe a potassium supplement that is taken orally. However, if the patient’s condition is serious enough, the supplement will be administered by infusion. Use of potassium supplements can have side effects such as stomach irritation and cause vomiting. Potassium supplements given by infusion should be channeled slowly to avoid the possibility of heart problems. Potassium supplements given to patients are generally potassium chloride (KCl) available in various forms of oral and intravenous fluids. For people with hypokalemia who also suffer from calcium stones in the body or patients with severe acidosis, can consume potassium citrate as a substitute for potassium chloride.
Monitor potassium levels. During the treatment period, the doctor will monitor the potassium levels in the patient’s body to ensure that his condition remains normal. This step is done to prevent the intake of potassium supplements are not excessive. Therefore, potassium levels are too high will cause serious complications.
Recommend a healthy diet high in potassium. Before the patient leaves the hospital, the patient will be given instructions to adjust the diet to keep the potassium intake maintained. In addition, doctors will also regulate a diet high in magnesium that is often associated with potassium, including recommending magnesium supplements.
After leaving the hospital, doctors will usually recommend patients to eat foods that contain potassium. If needed, the doctor will prescribe potassium and magnesium supplements. Therefore, magnesium deficiency can lead to potassium deficiency.
Prevention of Hypokalemia
Potassium deficiency can be avoided by keeping the potassium level in the blood remains in normal condition. There are some foods that can be consumed to keep potassium levels normal, among them:
- FIG fruit.
- Peanut butter.
Certain medications can also be a cause of a person suffering from potassium deficiency. Therefore, avoid excessive use of diuretic drugs to reduce the risk of this condition and it is advisable to always consult a physician while undergoing treatment.