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Symptoms and Signs – Differential Diagnosis of Hypokalaemia
Gastrointestinal loss
Vomiting, diarrhoea, villous adenoma, VIPoma, fistulae, ileostomies
Renal loss
Excess mineralocortcoids (--potassium excretion)
Hyperaldosteronism
Increased Glucocorticoids: Cushing's syndrome, liquorice (inhibits 11 [3-hydroxysteroid
dehydrogenase and l glucocorticoid metabolism), 11 [3-hydroxysteroid
dehydrogenase deficiency
Congenital adrenal hyperplasia (11 [3-hydroxylase and 17 cr-hydroxylase
deficiency)
Increased Na+ delivery to distal nephron (-> i Na+ absorption and K' secretion)
Osmotic diuresis (e.g. in glycosuria)
Diuretics: thiazides and loop diuretics (also T aldosterone secretion)
Bartter's syndrome, Gitelman's syndrome
Others
Hypomagnesaemia
Renal tubular acidosis (type I & II)
Renal tubular damage
Liddle's syndrome (autosomal dominant condition, primary T in collecting tubule
sodium reabsorption and often potassium secretion)
Redistribution into the cells
Insulin, beta-agonists, alkalosis
Gastrointestinal loss
Vomiting, diarrhoea, villous adenoma, VIPoma, fistulae, ileostomies
Renal loss
Excess mineralocortcoids (--potassium excretion)
Hyperaldosteronism
Increased Glucocorticoids: Cushing's syndrome, liquorice (inhibits 11 [3-hydroxysteroid
dehydrogenase and l glucocorticoid metabolism), 11 [3-hydroxysteroid
dehydrogenase deficiency
Congenital adrenal hyperplasia (11 [3-hydroxylase and 17 cr-hydroxylase
deficiency)
Increased Na+ delivery to distal nephron (-> i Na+ absorption and K' secretion)
Osmotic diuresis (e.g. in glycosuria)
Diuretics: thiazides and loop diuretics (also T aldosterone secretion)
Bartter's syndrome, Gitelman's syndrome
Others
Hypomagnesaemia
Renal tubular acidosis (type I & II)
Renal tubular damage
Liddle's syndrome (autosomal dominant condition, primary T in collecting tubule
sodium reabsorption and often potassium secretion)
Redistribution into the cells
Insulin, beta-agonists, alkalosis
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