Alkalosis
Hypokalemia has metabolic effects on the organism. In particular, the electrolyte concentrations and the pH value of the blood change. If the potassium concentration in the blood is too low, the organism activates compensation mechanisms to stabilize the concentration, as the serum potassium must be kept within a narrow concentration range to prevent cardiac arrhythmia.
The decisive organ for this compensation is the kidney. In the kidney, potassium ions are exchanged for hydrogen atoms via specific exchange proteins. Potassium is absorbed and hydrogen atoms are excreted. Due to the loss of hydrogen, the pH value of the blood shifts to the alkaline range, i.e. it is below 7.35. Since this pH deviation also does not correspond to the norm, the lungs switch on as a compensation mechanism for the pH value: Hypoventilation, i.e. a reduction in the respiratory rate, takes place.
Cardiac arrhythmias
The concentration of potassium in the blood is regulated within a narrow range: Physiologically, it lies between 3.6 and 5.2 mmol/l. This strict regulation is extremely important to avoid cardiac arrhythmia. Both hyper- and hypokalemia have an arrhythmogenic effect on the heart muscle cells.
Hypokalemia causes a decrease in the membrane potential of the heart muscle cells. This increases the risk of spontaneous arrhythmias. This can trigger life-threatening cardiac arrhythmias, in the worst case a ventricular fibrillation. For this reason, potassium levels must be checked regularly and deviations from the normal values must be compensated for urgently, even with drug therapy, especially when taking diuretics.
Insulin and its influence
Insulin is a hormone of the pancreas that is produced and secreted with food intake and digestion and has a decisive influence on the sugar level of the blood. Insulin causes the absorption of sugar in the form of glucose into the cells, which is essential for their survival, and the transport of potassium into the cell interior. Insulin can therefore significantly lower the potassium level.
A high insulin level is therefore a potential risk factor for hypokalemia. In medicine, this is used in the case of acute hyperkalemia, which can also be life-threatening. By administering glucose and insulin simultaneously, the potassium level can be lowered considerably. It is important to ensure that the correct dose is administered so that hypokalemia does not fatally occur in return.
