Etiology and symptoms of severe hypokalemia in emergency department patients

Marti, Grischa; Schwarz, Christoph; Leichtle, Alexander Benedikt; Fiedler, Georg Martin; Arampatzis, Spyridon; Exadaktylos, Aristomenis K.; Lindner, Gregor

doi:10.1097/mej.0b013e3283643801

Cited by 45 publications

(77 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Marti et al [12] reported that of 43,805 ED patients with serum potassium measurement, 4,826 (11%) had a potassium less than 3.5 mEq/L at presentation. Fifty-three patients had severe hypokalemia (<2.6 mEq/L), of which 26 (49%) were symptomatic and 20 (69%) had electrocardiogram changes.…”

Section: Introductionmentioning

confidence: 99%

A retrospective study of emergency department potassium disturbances: severity, treatment, and outcomes

2017

View full text Add to dashboard Cite

ObjectiveDisturbances in potassium (K) levels are relatively common and may be associated with significant morbidity and mortality; however, treatments vary. Our purpose was to determine the incidence, treatments, and outcomes associated with hyperkalemia and hypokalemia in emergency department (ED) patients.MethodsWe performed a structured, retrospective review of electronic medical records of consecutive adult ED patients with K measured while in the ED. Demographic, clinical, and laboratory data as well as treatments, disposition, and in-hospital complications were collected. Univariate and multivariate analyses, presented as adjusted odds ratios, were used to compare outcomes by K levels.ResultsOf 100,260 visits in 2014, an ED K level was ordered in 48,827 (49%). A total of 1,738 patients (3.6%) were excluded because of sample hemolysis. The K was low (<3.5 mEq/L) in 5.5%, normal (3.5 to 5.0 mEq/L) in 90.9%, and elevated (>5.0 mEq/L) in 3.6% of patients. Patients with hyperkalemia were older (64 vs. 49 years, P<0.001) and more likely male (58% vs. 40%, P<0.001). Treatment for hyperkalemia varied greatly. After adjusting for confounders, both hyperkalemia and hypokalemia were associated with inpatient hospitalization and death. At least one medication was used to manage hyperkalemia in 11.5% of patients with a K of 5.1 to 5.4 mEq/L, 36.4% of those with a K 5.5 to 6 mEq/L and 77.0% of the cohort with K >6 mEq/L.ConclusionHyperkalemia or hypokalemia occur in 1 of 11 ED patients and are associated with inpatient admission and mortality. Treatment of hyperkalemia varies greatly suggesting the need for evidence-based treatment guidelines.

show abstract

Section: Introductionmentioning

confidence: 99%

A retrospective study of emergency department potassium disturbances: severity, treatment, and outcomes

2017

View full text Add to dashboard Cite

show abstract

“…Disorders of serum sodium and potassium are common in outpatients and were found to be present in more than 10% of patients, respectively [1,2,3]. Many factors have been found to be associated with the development of dysnatremias and dyskalemias, with diuretic therapy being the most prominent [4,5].…”

Section: Introductionmentioning

confidence: 99%

Age-Related Variety in Electrolyte Levels and Prevalence of Dysnatremias and Dyskalemias in Patients Presenting to the Emergency Department

Lindner¹,

Pfortmüller²,

Leichtle

et al. 2014

Gerontology

Self Cite

View full text Add to dashboard Cite

Background: It was found that age and female gender are predisposing factors for hyponatremia in patients taking thiazides. Objective: To investigate whether a relationship exists between age and gender and serum sodium and potassium as well as the prevalence rates in a large population of patients presenting to the emergency department of a university hospital. Methods: In this retrospective analysis we gathered data on age, gender and current diuretic medication of all patients admitted to the emergency department of a large university hospital with measurement of serum sodium and potassium between January 1, 2009 and December 31, 2010. Prevalence rates of and risk factors for electrolyte disorders were calculated on the basis of these data. Results: A total of 20,667 patients were included in the analysis. Serum sodium levels declined significantly with increasing age while serum potassium rose, independent of diuretic medication at presentation. The prevalence rates of hyponatremia and hyperkalemia increased from 2.3% for hyponatremia in patients aged 16-21 years to 16.9% in patients aged >80 years and from 0.8% for hyperkalemia to 10.4%. In the regression analysis, age >60 years was a predictor for the presence of hyponatremia and hyperkalemia as was current use of diuretic medication. Male gender was associated with a decreased prevalence of hyponatremia and hypokalemia, while it was a predictor of hyperkalemia. Conclusions: Sodium levels were lower with increasing age, independent of diuretic intake, while potassium levels were higher. We found dramatically increasing prevalences of hyponatremia and hyperkalemia with increasing age, while no such effect could be found for hypernatremia and hypokalemia.

show abstract

“…Entre las más comunes están el ayuno, el uso de diuréticos o de beta 2 adrenérgicos, las infusiones de dextrosa y/o insulina y las pérdidas gastrointestinales (4)(5)(6)(7)(8). Por lo general, su corrección es sencilla, pero en algunas ocasiones es recurrente y de tratamiento difícil.…”

Section: Discussionunclassified

“…Por lo general, su corrección es sencilla, pero en algunas ocasiones es recurrente y de tratamiento difícil. Un nivel de potasio muy bajo (menor de 2,6 mEql/L) puede poner en riesgo la vida del paciente por parálisis, rabdomiolisis, insuficiencia respiratoria, arritmias o paro cardíaco; además, dificulta el tratamiento de otras enfermedades por íleo paralítico, que impide la nutrición y la tolerancia a los medicamentos (7,(9)(10)(11). Por lo anterior, es fundamental buscar sistemáticamente las causas corregibles, con el fin de instaurar un tratamiento apropiado, dirigido, y evitar así complicaciones graves (8 Figura 2.…”

Section: Discussionunclassified

Hipopotasemia recurrente y de difícil control en un paciente con leucemia linfoide aguda

Nieto-Ríos

Serna-Higuita

Valencia-Chicué

et al. 2015

iatreia

View full text Add to dashboard Cite

Etiology and symptoms of severe hypokalemia in emergency department patients

Abstract: Hypokalemia is common in the emergency department. Severe hypokalemia is often symptomatic and more than two-thirds of patients show ECG changes.

Cited by 45 publications

References 0 publications

A retrospective study of emergency department potassium disturbances: severity, treatment, and outcomes

A retrospective study of emergency department potassium disturbances: severity, treatment, and outcomes

Age-Related Variety in Electrolyte Levels and Prevalence of Dysnatremias and Dyskalemias in Patients Presenting to the Emergency Department

Hipopotasemia recurrente y de difícil control en un paciente con leucemia linfoide aguda

Contact Info

Product

Resources

About