Analysis of Hypokalemia in Emergency Patients / 대한신장학회잡지

OBJECTIVES: Hypokalemia is one of the most common electrolyte disorders encountered in clinical medicine. It is important electrolyte disorder because it is account for neuromuscular, cardiovascular and renal disturbance. But there are few studies to evaluate the incidence and cause of hypokalemia in emergency patients. Present study was performed to evaluate the incidence and cause of hypokalemia and coincidental changes of other electrolyte and chemical parameters of blood and urine. METHODS: Hypokalemia was defined as a serum potassium concentration less than 3.5mEq/L. A total 80 medical patient without renal failure were prospectively studied for 62 days. Electrolytes and chemical parameters of the blood and urine were determined at emergency room. RESULTS: 1) Of medical inpatients through emergency room, hypokalemia was detected in high frequency(32%) and mild degree(mean; 3.1+/-0.1mEq/L). 2) The most common cause of hypokalemia was diuretics(23%), other causes were vomiting, SIADH, diarrhea, alkalemia, and unidentified cause(each; 15.4%). 3) Compared to the normokalemic group, the hypokalemic group showed significant decrease in urinary anion gap(P=0.003). 4) There was no significant difference of spot urine potassium concentrations between renal and extrarenal origin of hypokalemia. CONCLUSION: The hypokalemia in emergency patients was detected in high frequency and mild degree. Urine anion gap was significantly decreased in hypokalemic group than normokalemic group. Spot urine potassium concentration was less effective in differentiation of renal and extrarenal origin of hypokalemia.

Correlation of Urine Ammonium with Urine Osmolal Gap in High Anion Gap Matabolic Acidosis: Comparison to Urine Anion Gap / 대한내과학회지

OBJECTIVES: Urine anion gap(UAG) and urine osmolal gap(UOG) were proposed as indirect measures of urine ammonium(NF4+). While the former is known to have its usefulness limited to hyperchloremic metabolic acidosis, the latter is reported to have its correlation with urine NE4+ in ketoacidosis. This study was undertaken to evaluate the correlation of urine NH with IJOG in high anion gap metabolic acidosis(AGMA) and to compare it with UAG. METHODS: We measured urine NH' by enzymatic determination, UOG(=0.5 X [urine osmolality-{2 X (Na++K+)+urea+glucose)]), and UAG(=Na++K+-Cl-) in 18 patients(serum AG=24.4+/-1.6mmol/L ) with AGMA. RESULTS: When they were grouped into those with acute disorders(n=11) and those with chronic disorder(n=7), urine Nk4+ concentration was higher (p40mmol/d) had the UOG>40mmol/L. CONCLUSION: In contrast to the UAG, the UOG has a significant correlation with urine NH4+ in AGMA.