Hypokalemia is a condition when the body lacks potassium or potassium. This condition can be experienced by anyone, especially those with diarrhea or vomiting. Treatment of hypokalemia needs to be done immediately to prevent serious complications, such as heart problems.

Potassium is a mineral in the body that controls the function of nerve and muscle cells, especially the heart muscle. Potassium also plays a role in maintaining the balance of body fluids and regulating blood pressure. When the level of potassium in the body decreases, various symptoms will appear, depending on the amount of potassium lost.

Causes of Hypokalemia

Hypokalemia occurs when the body excretes too much potassium. This condition can be caused by several factors. The most common causes of potassium deficiency are:

  • Throws up
  • Excess diarrhea
  • Kidney disease or disorders of the adrenal glands
  • Take diuretic drugs

Although rare, potassium deficiency can also be caused by the following factors:

  • Deficiency of folic acid
  • Diabetic ketoacidosis
  • Low levels of magnesium in the body ( hypomagnesemia )
  • Take asthma medications or antibiotics
  • Long-term use of laxatives
  • Excessive consumption of alcoholic beverages
  • Smoking habit

Several syndromes can also cause low levels of potassium in the body, including Cushing's syndrome, Gitelman's syndrome, Liddle's syndrome, Bartter's syndrome, and Fanconi's syndrome.

Symptoms of Hypokalemia

Symptoms can appear when potassium levels in the body are low, which is below 3.6 mmol/L. Even so, mild hypokalemia generally does not cause symptoms.

The following are the initial complaints that appear in patients with hypokalemia:

  • Nausea and vomiting
  • Loss of appetite
  • Constipation or constipation
  • Body feels weak
  • pins and needles
  • Muscle cramp
  • Heart beat

Very low levels of potassium in the blood, which is less than 2.5 mmol/L, can be fatal. This condition is classified as severe hypokalemia. Some of the symptoms of severe hypokalemia that can appear are:

  • Paralytic ileus
  • Paralysis
  • Heart rhythm disturbances ( arrhythmias )
  • Stop breathing

Heart rhythm disturbances due to hypokalemia can be too slow ( bradycardia ), too fast (tachycardia), or irregular, such as atrial fibrillation . This condition is more at risk for people who take the drug digoxin .

When to see a doctor

Immediately consult a doctor if you experience symptoms of hypokalemia, especially after vomiting, diarrhea, taking diuretic drugs , or suffering from kidney disease . Treatment needs to be done immediately to prevent complications.

Check with your doctor if you have vomiting for more than 1 day or diarrhea for more than 2 days. Vomiting and diarrhea can cause dehydration and potassium deficiency, so immediate treatment is needed.

Discuss with your doctor if you suffer from a disease that requires taking diuretic drugs in the long term. Diuretic drugs are one of the causes of hypokalemia. The doctor can reduce the dose or replace the type of diuretic drug that does not trigger hypokalemia, such as spironolactone  or amiloride .

If you suffer from kidney disease, carry out regular health checks as directed by your doctor. The kidneys function to regulate and maintain normal levels of potassium in the body through excretion of urine. When kidney function is impaired, potassium levels in the body will also be disrupted.

Immediately go to the emergency room if the symptoms of hypokalemia are accompanied by complaints of palpitations, weakness, or paralysis . Handling needs to be done immediately because this condition can cause death.

Diagnosis of Hypokalemia

The doctor will ask about the symptoms that appear and check the medical history to find out possible diseases that can trigger vomiting or diarrhea. The doctor will also measure the patient's blood pressure, body temperature, and heart rate, because hypokalemia can affect all three of these.

To measure potassium levels in the blood, the doctor will do a blood test. Normal potassium levels are 3.7-5.2 mmol/L. If the potassium level is lower than this number, then the patient is diagnosed with hypokalemia.

In addition to blood tests, urine tests are also carried out to measure the amount of potassium that is wasted with urine.

If the patient has a history of heart disease, the doctor will do an electrocardiogram (EKG) , to detect heart rhythm disturbances caused by low potassium levels in the body.

Treatment of Hypokalemia

The method of treating hypokalemia depends on the low potassium level, the underlying cause, and the patient's ability to take fluids or medications. If the condition is serious enough, the patient must be hospitalized until the potassium level in the body returns to normal.

The following are several stages of treating hypokalemia:

Treating the cause of hypokalemia

After the cause of potassium deficiency is known with certainty, the doctor will treat the cause. For example, the doctor may give anti-diarrheal drugs, such as loperamide or bismuth subsalicylate , if the hypokalemia is caused by diarrhea.

Restores potassium levels

Mild hypokalemia can be treated by taking potassium supplements . However, in severe hypokalemia, potassium intake needs to be given via potassium chloride infusion.

The infusion dose will be adjusted according to the level of potassium in the blood and given slowly to prevent the risk of heart problems. If other types of electrolyte levels are disturbed, the doctor will also treat this condition.

Monitor potassium levels

While undergoing treatment at the hospital, the doctor will monitor the patient's potassium levels through a blood test or urine test. This action is taken to prevent excessive increase in potassium levels ( hyperkalemia ), because high potassium levels can also cause serious complications.

To maintain normal potassium levels, patients are advised to eat foods that are high in potassium, such as beans, spinach, salmon and carrots. The doctor will also prescribe magnesium supplements, because magnesium levels in the body can decrease as potassium is lost.

Hypokalemia Complications

Early detection and treatment of hypokalemia is necessary to prevent complications. One of the most dangerous complications is arrhythmia. This complication is at risk of occurring in patients with hypokalemia who also suffer from heart problems.

Potassium deficiency is also at risk of causing other complications if not handled properly. These complications include:

  • Rhabdomyolysis
  • Paralytic ileus
  • Brain disorders in people with cirrhosis (hepatic encephalopathy)
  • Kidney illness
  • Respiratory muscle paralysis

Prevention of hypokalemia

Steps to prevent hypokalemia depend on the cause. If potassium deficiency is caused by diarrhea, prevention can be done by diligently washing hands, consuming drinks and foods that have been cooked thoroughly, and drinking lots of water.

If potassium deficiency occurs due to persistent vomiting, prevention is by consuming sugary drinks or fruit juices, eating small but regular meals, and not lying down immediately after eating.

In addition, take diuretic drugs as directed by your doctor. This drug will make users urinate more frequently so that potassium can be wasted with urine. Keep in mind, do routine control to the doctor while using diuretic drugs.

Potassium deficiency can also be avoided by consuming foods high in potassium so that potassium levels in the blood are maintained. Some types of foods that are high in potassium are:

  • Fruits, such as bananas, oranges, and avocados
  • Vegetables, such as tomatoes, spinach, and carrots
  • Beef
  • Fish
  • Nuts
  • Wheat
  • Milk

In addition, consult your nutritionist again to prevent the risk of developing hyperkalemia, especially if you are taking potassium supplements or have kidney disease.

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