Analysis of Hypokalemia in Emergency Patients / 대한신장학회잡지

ABSTRACT

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.