Hypokalemia: review of current state of problem

The determination of blood electrolytes is an important task not only at the stage of intensive care, but also in the outpatient routine practice of specialists, regardless of their specialty. This article discusses some aspects of reducing the level of potassium in blood plasma. Understanding the mechanisms and conditions that lead to deviations in the concentration of potassium in the blood is important for making decisions about timely correction. At the present stage of development of medical science, when the level of potassium in the blood serum is below 4 mmol/l., the risk of death and cardiovascular catastrophes may increase. In this regard, the values of potassium below 4 mmol/l are considered as the level from which it is rational to decide on the start of the use of potassium preparations. Also, this level is the target level for the correction of potassium in patients with initially low levels of potassium. Correction of the level of potassium above 4 mmol/l helps to further reduce the level of systolic and diastolic arterial pressure in hypertension. Reception of RAAS blockers, beta-blockers, potassium-saving diuretics, taking insulin, prednisolone, amphotopicin B can contribute to an increase in the level of potassium. However, in real clinical practice, the risks of developing hyperkalemia are 13.5 times lower than the risk of hypokalemia, since evolutionarily the human body is better adapted to combat hyperkalemia. The excretion of potassium by the kidneys does not change significantly until the rate of club-like filtration decreases below 15-20 ml/min. In patients with terminal CKD, adaptation to reduced potassium secretion by the kidneys occurs through increased potassium secretion in the colon. Discharging a patient from a hospital does not guarantee his normal levels of potassium. In this regard, it should also be subject to an assessment of the level of electrolytes. Intake of potassium should be long, at least 1-3 months with a reassessment after 6-12 months after normalization of the level of potassium.

hypokalemia, potassium drugs, target potassium levels, mortality, blood pressure, diabetes

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