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Evaluation of Hypokalemia

Educational Objective
To understand how to interpret the results of diagnostic tests and apply them clinically.
1 Credit CME

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Article Information

Corresponding Author: Morgan E. Grams, MD, PhD, Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, 2024 E Monument St, Ste 2-638, Baltimore, MD 21205 (mgrams2@jhmi.edu).

Correction: This article was corrected on May 11, 2021, to correct an error in the Figure that included acute intracellular sodium shift as a potential readily identifiable cause of hypokalemia. This was corrected to instead include acute intracellular potassium shift as a potential readily identifiable cause of hypokalemia.

Conflict of Interest Disclosures: Dr Grams reported receiving grants from the National Kidney Foundation outside the submitted work and receiving funding from the National Institute of Diabetes and Digestive and Kidney Diseases and travel support from Dialysis Clinic Inc to speak on risk calculators at an annual director’s meeting in May 2019. Dr Hoorn reported receiving grants from the Dutch Kidney Foundation outside the submitted work. All authors reported participating in a KDIGO meeting on potassium management in October 2018.

Additional Contributions: We thank the patient for granting permission to publish this information.

References
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Kovesdy  CP , Matsushita  K , Sang  Y ,  et al; CKD Prognosis Consortium.  Serum potassium and adverse outcomes across the range of kidney function.   Eur Heart J. 2018;39(17):1535-1542. PubMedGoogle ScholarCrossref
2.
Clase  CM , Carrero  JJ , Ellison  DH ,  et al; Conference Participants.  Potassium homeostasis and management of dyskalemia in kidney diseases: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference.   Kidney Int. 2020;97(1):42-61.PubMedGoogle ScholarCrossref
3.
Sodi  R , Davison  AS , Holmes  E , Hine  TJ , Roberts  NB .  The phenomenon of seasonal pseudohypokalemia: effects of ambient temperature, plasma glucose and role for sodium-potassium-exchanging-ATPase.   Clin Biochem. 2009;42(9):813-818.PubMedGoogle ScholarCrossref
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Palmer  BF , Clegg  DJ .  Physiology and pathophysiology of potassium homeostasis.   Am J Kidney Dis. 2019;74(5):682-695.PubMedGoogle ScholarCrossref
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Brown  JM , Siddiqui  M , Calhoun  DA ,  et al.  The unrecognized prevalence of primary aldosteronism.   Ann Intern Med. 2020;173(1):10-20.PubMedGoogle ScholarCrossref
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Kieboom  BC , Kiefte-de Jong  JC , Eijgelsheim  M ,  et al.  Proton pump inhibitors and hypomagnesemia in the general population: a population-based cohort study.   Am J Kidney Dis. 2015;66(5):775-782.PubMedGoogle ScholarCrossref
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Srinutta  T , Chewcharat  A , Takkavatakarn  K ,  et al.  Proton pump inhibitors and hypomagnesemia.   Medicine (Baltimore). 2019;98(44):e17788.PubMedGoogle Scholar
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Palmer  BF , Clegg  DJ .  The use of selected urine chemistries in the diagnosis of kidney disorders.   Clin J Am Soc Nephrol. 2019;14(2):306-316.PubMedGoogle ScholarCrossref
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Wu  KL , Cheng  CJ , Sung  CC ,  et al.  Identification of the causes for chronic hypokalemia.   Am J Med. 2017;130(7):846-855.PubMedGoogle ScholarCrossref
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