common acid-base disorders associated with hypokalaemia

Last edited 07/2024

common acid-base disorders associated with hypokalaemia

type of disturbance

key feature

hypokalaemic acidosis

diarrhoea, laxative misuse, and other lower gastrointestinal loss

normal serum chloride

diabetic ketoacidosis

high ketones; potassium drops after IV insulin is administered

renal tubular acidosis

associated with autoimmune disease (type 1) and Fanconi's syndrome (type 2)

hypokalaemic alkalosis

 

vomiting and other upper GI loss

low serum chloride

mineralocorticoid excess (such as primary hyperaldosteronism)

high blood pressure

hereditary renal channelopathies:

 

Bartter's syndrome

presents in the childhood

Gitelman's syndrome

often asymptomatic, presents in the adulthood

Liddle's syndrome

high blood pressure, low rennin and aldosterone

diuretic use

drug history

Reference:

(1) McDonald TJ, Oram RA, Vaidya B. Investigating hyperkalaemia in adults. BMJ. 2015;351:4762.