Drug induced hypokalemia: a retrospective study

To study the association between the use of diuretics, steroids, or their combination and hypokalemia. One hundred fifty patients receiving diuretics, steroids, or both as a treatment for different medical problems [none of them was receiving potassium supplement] at Al-Hussain hospital in Karbala city, Iraq, were categorized into 3 groups according to the medication used whether it was diuretics, steroids, or combination of both. After detailed medical history and careful physical examination to detect any clinical feature of hypokalemia, electrocardiography and serum potassium estimation was done for every patient. Hypokalemia was considered when the serum potassium was less than 3.5 mm/1. The mean serum potassium for the study subjects was 3.9 +/- 0.61mmol/l, and 26.7% were found to have hypokalemia. Mild hypokalemia was present in 22% in patients receiving diuretics, and 14% in patients receiving steroids; and 36% in patients receiving combination of them. Moderate hypokalemia was found in 8% of patients receiving diuretics and steroids combination. Only 12% of patients in this study showed symptoms suggestive of hypokalemia [muscle weakness, fatigue, cramps], the majority being in patients receiving combination of diuretics and steroids. No physical signs of hypokalemia were detected in any patient of the study subjects. The study showed an association between decreased serum potassium concentrations with increasing duration of treatment. Electrocardiographic changes of hypokalemia were present in 6% of our patients. Hypokalemia is a common electrolyte disturbance associated with the use of diuretics and/ or steroids which should be looked after in order to avoid its serious consequences