Hypokalemia due to Extrarenal Potassium Loss

Aka: Hypokalemia due to Extrarenal Potassium Loss, Extrarenal Potassium Loss, Hypokalemia with Excessive Renal Losses

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II. Labs

  1. Hypokalemia with Urine Potassium < 20 meq/day

III. Causes: Normal Acid-Base Status and Hypokalemia

  1. Chronic Diarrhea
  2. Acute Leukemia
  3. Aminoglycosides
  4. High dose Penicillin
  5. Colonoscopy Bowel Preparation
  6. Hypomagnesemia
    1. Intracellular Magnesium (99% of body stores) is not reflected by Serum Magnesium level
    2. Consider empiric Magnesium Replacement in refractory Hypomagnesemia
  7. Constant GI loss and inadequate intake (<10-20 meq/day)
  8. Skin losses from sweating

IV. Causes: Metabolic Acidosis and Hypokalemia

  1. Acute Diarrhea
  2. Amphotericin
  3. Diabetic Ketoacidosis
  4. Laxative abuse
  5. Intestinal or biliary fistula
  6. Ureterostomy
  7. Toluene

V. Causes: Metabolic Alkalosis and Hypokalemia

  1. Gastrointestinal loss (Consider Bulimia)
    1. Vomiting
    2. Nasogastric suction
  2. Discontinued Diuretics

VI. References

  1. Kim (2023) Am Fam Physician 107(1): 59-70 [PubMed]

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