Risk groups for deficiency
- Women and men, respectively, >= 65 years of age (due to insufficient food intake, frequent use of medications – diuretics, laxatives).
- Discussed an increased need for athletes and heavy workers (after several hours of continuous exercise about 300 mg potassium / L are lost through sweat).
Persons with
- Increased gastrointestinal losses (due to severe diarrhea (diarrhea), vomiting, or intestinal fistulae).
- Taking laxatives and beta-blockers (leading to high losses).
- Increased renal potassium excretion, due to intake of thiazide-type diuretics and loop diuretics, in renal insufficiency and osmotic diuresis in diabetes mellitus.
- Intake of diuretics, antibiotics and alcohol (due to the massive gastrointestinal cation losses occur hypomagnesemia, which increases the permeability of potassium through the potassium channels, leading to renal potassium losses – in addition, the high permeability of potassium affects the myocardial action potential)
- Excessive sodium intake (can lead to potassium depletion).
- Increased intracellular potassium uptake (during acidosis treatment, glucose–insulin therapy).
As a result of increased potassium losses, the risk of hypokalemia (potassium deficiency; potassium concentration < 3.5 mmol/L) increases. In addition, high potassium excretion may increase the arryhthmogenic effect of cardiac glycosides.
Risk groups for excess – risk of hyperkalemia (potassium excess; potassium concentration > 5.5 mmol/L)
Individuals with
- Increased intake, for example, through excessive oral or parenteral nutrition, potassium-containing drugs or saline substitutes, supplements.
- Age >= 65 years
- Unknown renal dysfunction
- Heart failure
- Hypoaldosteronism
- Tendency to acidosis
- High alcohol consumption
- Diabetes mellitus with disturbances in autonomic cardiovascular function
- Decreased renal potassium excretion (in acute and chronic renal insufficiency, adrenocortical insufficiency – Addison’s disease, intake of drugs – heparin, potassium-sparing diuretics, aldosterone antagonists, ACE (angiotensin-converting enzyme) inhibitors, spironolactone, nonsteroidal anti-inflammatory drugs, cyclosporine A, and peripheral analgesics.
- Distribution disorders from the intracellular space to the extracellular space – for example, in respiratory and metabolic acidosis, trauma, burns, rhabdomyolysis, acute hemolysis, there is a release of potassium from the tissues
An increase in extracellular potassium concentration decreases the effect of cardiac glycosides.
