A simple and rapid approach to hypokalemic paralysis.
Hypokalemia with paralysis (HP) is a potentially reversible medical emergency. It is primarily the result of either hypokalemic periodic paralysis (HPP) caused by an enhanced shift of potassium (K(+)) into cells or non-HPP resulting from excessive K(+) loss. Failure to make a distinction between HPP and non-HPP could lead to improper management. The use of spot urine for K(+) excretion rate and evaluation of blood acid-base status could be clinically beneficial in the diagnosis and management. A very low rate of K(+) excretion coupled with the absence of a metabolic acid-base disorder suggests HPP, whereas a high rate of K(+) excretion accompanied by either metabolic alkalosis or metabolic acidosis favors non-HPP. The therapy of HPP requires only small doses of potassium chloride (KCl) to avoid rebound hyperkalemia. In contrast, higher doses of KCl should be administered to replete the large K(+) deficiency in non-HPP.
Division of Nephrology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C. L521116@ndmctsgh.edu.tw
Shih-Hua
SH
Lin
Jainn-Shiun
JS
Chiu
Chin-Wang
CW
Hsu
Tom
T
Chau
D000136:Acid-Base Equilibrium; D000328:Adult; D001477:Bartter Syndrome / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D003937:Diagnosis, Differential; D004632:Emergency Medical Services / Q000379:methods; D005260:Female; D006801:Humans; D006980:Hyperthyroidism / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D020514:Hypokalemic Periodic Paralysis / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000628:therapy* / Q000652:urine; D007262:Infusions, Intravenous; D008297:Male; D011188:Potassium / Q000652:urine; D011189:Potassium Chloride / Q000008:administration & dosage; D012859:Sjogren's Syndrome / Q000175:diagnosis / Q000628:therapy; D016896:Treatment Outcome
D011189:Potassium Chloride; D011188:Potassium