Disorders and Drugs Associated with Altered Serum Potassium Levels
Increased Serum Potassium (Hyperkalemia)
Inappropriate Cellular Metabolism
- Acidosis
- Insulin deficiency
- Hypoaldosteronism
- Cell necrosis (trauma, burns, hemolysis, antineoplastic therapy)
- Addison's disease
- Acute renal failure
- Chronic interstitial nephritis
- Tubular unresponsiveness to aldosterone
- Hypoaldosteronism
- Salt substitutes
- Potassium supplements (oral or IV)
- Potassium salts of antibiotics
- Transfusion of old banked blood
- IV therapy with inadequate potassium supplementation
- Aldosterone antagonists
- Potassium preparations of antibiotics
- Amphotericin B
- Tetracycline
- Heparin
- Epinephrine
- Marijuana
- Isoniazid
Decreased Serum Potassium (Hypokalemia)
Inappropriate Cellular Metabolism
- Alkalosis
- Insulin excess
- Familial periodic paralysis
- Rapid cell generation (leukemia, treated megaloblastic anemia)
- Chronic excessive licorice ingestion
- Gastrointestinal loss (vomiting, diarrhea, nasogastric suction, fistula)
- Excessive diuresis
- Hyperaldosteronism
- Laxative abuse
- Hypomagnesemia
- Renal tubular acidosis
- Diaphoresis
- Thyrotoxicosis
- Cushing's syndrome
- Anorexia nervosa
- Diet deficient in meat and vegetables
- Clay eating (binds potassium and prevents absorption)
- Furosemide
- Ethacrynic acid
- Thiazide diuretics
- Insulin
- Aspirin
- Prednisone
- Cortisone
- Gentamicin
- Polymyxin B
- Lithium carbonate
- Sodium polystyrene sulfonate (Kayexalate)
- Ammonium chloride
- Aldosterone
- Laxatives
Adapted from Sacher, RA, and McPherson, RA: Widmann's Clinical Interpretation of Laboratory Tests, ed 11. FA Davis, Philadelphia, 2000, p. 402, with Permission.