What does the prevalence of low potassium (hypokalemia) in 21% of hospital patients really tell us and how is it being addressed?
According to the National Institute of Health, more than 1 in 5 hospital patients has hypokalemia (low potassium) and often this is the result of a side effect of heart related medications (ibid.):
...Insufficient potassium intakes can increase blood pressure, kidney stone risk, bone turnover, urinary calcium excretion, and salt sensitivity (meaning that changes in sodium intakes affect blood pressure to a greater than normal extent) 1.
Severe potassium deficiency can cause hypokalemia, (serum potassium level less than about 3.6 mmol/L) [3,7,8]. Hypokalemia affects up to 21% of hospitalized patients, usually because of the use of diuretics and other medications [30,31], but it is rare among healthy people with normal kidney function.
Mild hypokalemia is characterized by constipation, fatigue, muscle weakness, and malaise [3]. Moderate to severe hypokalemia (serum potassium level less than about 2.5 mmol/L) can cause polyuria (large volume of dilute urine); encephalopathy in patients with kidney disease; glucose intolerance; muscular paralysis; poor respiration; and cardiac arrhythmias, especially in individuals with underlying heart disease [1,3,7]. Severe hypokalemia can be life threatening because of its effects on muscle contraction and, hence, cardiac function [5].
...Hypokalemia is rarely caused by low dietary potassium intake alone, but it can result from diarrhea due to potassium losses in the stool. It can also result from vomiting, which produces metabolic alkalosis, leading to potassium losses in the kidneys. Hypokalemia can also be caused by refeeding syndrome (the metabolic response to initial refeeding after a starvation period) because of potassium’s movement into cells; laxative abuse; diuretic use; eating clay (a type of pica); heavy sweating; or dialysis [3,5,7,32,33]...
Magnesium depletion can contribute to hypokalemia by increasing urinary potassium losses [1,34,35]. It can also increase the risk of cardiac arrhythmias by decreasing intracellular potassium concentrations. More than 50% of individuals with clinically significant hypokalemia might have magnesium deficiency [35]. In people with hypomagnesemia and hypokalemia, both should be treated concurrently [7]...
From what I understand from the article, though, this measurement is somewhat limited in that most of the potassium is stored in the cells of the body, not in the blood (ibid.) and that measurement is rarely taken because of the difficulty. If so then:
is this percentage really a meaningful indicator of hypokalemia?
if so, is this addressed by doctors or hospital nutritionists?
if so, how?
if not, why not? What should be done?
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