hypokalemia - it is a symptom that has a low potassium content in the tissues.A suitable amount of potassium in the plasma of at least 3.5 mmol / l.Fall concentrations below that indicates the occurrence of electrolyte imbalance that under adequate care often causes severe damage in the patient.
metabolism in tissues is impossible without the participation of potassium.In tandem with sodium, it generates sodium-potassium balance, which is responsible for osmotic processes through cell membranes.This is necessary for normal functioning of nerve and muscle fibers.Do not go without potassium and acid-base processes.He also takes an active part in the work of the enzymes, and prevents water retention in the intercellular space.
With a significant imbalance in potassium often disrupt the normal operation of the heart (arrhythmia), nervous system (reduced reflexes, muscle weakness, decreased intestinal motility, dynamic ileus), respiratory system.Serious consequences for the normal
Causes of hypokalemia
There are three main reasons that can cause pathological changes associated with hypokalemia: insufficient penetration of potassium in the body, excessive excretion from the body and impaired movement of potassium at the cellular level.At insufficient intake of potassium with food affects hobby strict diet and overworking himself to death in order to achieve harmony or religious beliefs (an ascetic life).
rare cause of hypokalemia in our time is the eating of clay, which is called pica.A similar eating habits found in the traditions of men blacks living in South America.This constitutes potassium inactive compounds with iron and clay can not participate in the metabolic processes of the body.
excess excretion of potassium from the body is quite a common problem.This includes a lot of pathological conditions.The imbalance in the stomach and intestines, which is manifested frequent vomiting, profuse diarrhea.Intentional vomiting in people with mental disorders (anorexia, etc.).
uncontrolled intake of various drugs such as laxatives, certain antibiotics (such as penicillin), diuretics, corticosteroids (prednisolone), insulin, often cause symptoms of hypokalemia.Adrenal tumors, cirrhotic changes in the liver, primary and secondary kidney disease can lead to a significant reduction of potassium levels.Equally important is adequate intake in humans and other trace elements, such as magnesium exchange whose tissue is closely related with potassium.
There are rarer causes of hypokalemia.For example, Bartter syndrome, which is showing signs of hypokalemia in infants.Finally, the reason is connected with the wrong redistribution of potassium ions on the cellular level, leading to a delay potassium intracellularly.This process can be affected by incorrectly selected dose of insulin in the treatment of diabetes, treatment of excessive doses of vitamin B12 and folic acid in oncology practice, an overdose of adrenaline, alcohol poisoning.It should be noted that the identification of the true cause, cause symptoms of hypokalaemia, in each case, it is essential for effective treatment and safe recovery.
Symptoms of hypokalemia
Symptoms of the disease are varied and non-specific, can also be found at a number of other diseases.In the early stages, when the amount of potassium decreased slightly, the patient begins to bother unmotivated weakness and fatigue, even in the absence of significant physical activity and normal sleep.There are pain and weakness in the lower extremities, sometimes convulsions that at an early stage leads to a significant decrease in efficiency.Unfortunately, in this period, patients rarely come to the doctor, explaining his fortune to various reasons (stress, weather conditions, vitamin deficiencies).In the absence of adequate support, the potassium concentration in the plasma gradually decreases, which leads to aggravation of hypokalemia, manifested dysfunction of many organs.
Quite often when hypokalemia nervous system suffers.There are paresthesia (a feeling of "pins and needles", burning, tingling of the skin), numbness and weakness of the limbs, in severe cases, paralysis and paresis occur.Changing the mentality that is manifested by apathy, depression, decreased emotional background.Sleep does not bring a sense of vitality, sonlivost increases until lethargy.It disrupts the function of stomach and intestines by decreasing peristalsis.This is manifested by nausea, regurgitation, vomiting, constipation, flatulence, loss of appetite, in advanced cases, intestinal paralysis, which leads to a dynamic ileus.
Violations during hypokalemia also affect the basic function of the heart - anxiety and conduct electrical impulses.Against this background, there are significant changes in the ECG, in severe cases, beats and ventricular fibrillation, which often leads to death.Hypokalemia is particularly dangerous for patients with ischemic, host glycosides.These people, of course, are at risk and require special monitoring.It may lead to the tragedy of paralysis of muscles, especially intercostal breathing and that often leads to the need for resuscitation and transfer the patient on artificial respiration.
considerable professionalism requires the identification of symptoms of hypokalemia in young children.For understandable reasons, children can not properly express and characterize their feelings.The main symptoms of hypokalemia they are: polyuria (increased number of daily urine) and decreased blood pressure.A very important role in the formulation of correct diagnosis plays a comprehensive diagnosis.
Diagnosis of the disease involves collecting detailed medical history.After clarification of complaints necessarily need to understand the reasons for their occurrence.At the same time learn about the possibility of a patient's digestive dysfunction: frequent vomiting, diarrhea, may cause the patient himself in his gag reflex.
Recently hypokalemia common in young women with anorexia.It turns out a person adheres to strict diets or starvation.Be sure to find out what medications the patient takes.Some groups of antibiotics penicillin, diuretics, vitamins (folic acid, vitamin B12) insulin, the hormone (prednisolone) at wrong, uncontrolled use can significantly reduce the amount of potassium.It turns out the presence of chronic kidney disease, adrenal glands, liver, cancer, alcohol abuse.It is important to observe the rules of storage of blood after collection.Long stay tubes at room temperature leads to a false hypokalaemia and correct diagnosis difficult.
After the visit to the therapist, the patient often needs counseling related specialists: a neurologist, cardiologist, endocrinologist.Important laboratory studies is to determine the concentration of potassium in the blood serum, which is a rapid method of metering.Urine tests for electrolytes can also assist in establishing the diagnosis of hypokalemia.It reveals a decrease of potassium secretion by the kidneys up to 15 mmol / l, confirming the loss of potassium in the stomach and intestines.Conversely, an increase in its amount in the urine in violation of reabsorption by the renal tubules in the case of renal disease.
For accurate diagnosis of reducing the potassium content of the whole organism to repeat biochemical blood tests, renal function studies (sample Rehberg - determination of creatinine in urine and serum), a study of the abdominal cavity using ultrasound.For a survey of the functions of the heart auscultation appointed for hearing tones (shortening of 2 tones), blood pressure (tendency to hypotension), conduct an electrocardiogram (prolongation of the electrical systole, the shortening of the mechanical systole, the appearance of the tooth U).All diagnostic methods must be carried out in the complex, consistently and accurately to identify the full picture of this disease.
treatment of hypokalemia
correction of hypokalemia is assigned depending on its cause.When you receive a low potassium in the human body, it is recommended to establish a normal diet - the food should be healthy, full and balanced on the nutrients and trace elements.It is essential to abandon the hunger and strict diets.When excess excretion of potassium from the tissues and the violation of his cellular metabolism, it is necessary to eliminate all the risk factors.
Antibiotics should be acquitted, appointed only physician in adequate doses and timing.
Receiving corticosteroids in adrenal adenomas should take place under the close supervision of a doctor, and monitoring of all functions and systems.Treatment of type 2 diabetes (insulin-dependent) must be strictly matched to the dose in each case, a constant correction to different stages of the disease.
doses of folic acid and vitamin B12 in the treatment of megaloblastic anemia should be adequate and individually, prescribe a course with enough breaks in treatment.
Laxatives should be used for the treatment of constipation, strictly on doctor's advice after a thorough examination.It is strictly forbidden to use these tools for weight loss and the so-called "cleansing the body of toxins."
People induce vomiting who suffer from anorexia, it is strongly recommended to help the therapist.
is important to deal with alcoholism, to identify the disease, for which no long necessary treatment leads to hypokalemia (cirrhosis, advanced cancer, kidney disease).Eliminating all the factors that cause a lack of potassium in the blood plasma is an important step in the treatment of hypokalemia.
In some cases, as required replacement therapy, ie, compensation for the missing trace elements in organs and tissues.Potassium can be given in pill (Panangin, Asparkam), administered intravenously and intravenous-drip (infusion indicated for severe disease and as an emergency treatment).Doses of potassium should be properly selected in accordance with the results of analyzes of blood, urine, condition of the patient and its resistance to treatment.
When hypokalemia related to the violation of cellular metabolism, administration of drugs by intravenous potassium is prohibited, as it is resistant phenomenon of hyperglycemia.Used salts such as sodium chloride, potassium, bicarbonate, citrate, phosphate.In parenteral administration, the potassium salt is diluted with isotonic sodium chloride solution.Dilution potassium glucose solution is not applicable, since in this case insulin enhances redistribution of intracellular potassium and potassium deficiency exacerbates the phenomenon in the body.
If emergency situation requires rapid flooding the body of potassium salts, such treatment of hypokalemia held under the watchful supervision of the patient: ECG monitoring, checking motor functions, breathing, determination of potassium in the blood every four hours.This prevents the development of serious complications in the cardiovascular and nervous systems and the risk of hyperglycemia.With great care prescribed therapy for older people, especially those with severe diabetes and renal failure, and patients taking potassium-sparing diuretics (eg, spironolactone, Veroshpiron).These people quite high risk of overdose.In contrast, patients with coronary artery disease who regularly receiving cardiac glycosides, as well as patients receiving insulin in diabetic ketoacidosis, the dosage of potassium should be higher.
effectiveness of the treatment of hypokalemia and the timing of the reversal of the normal electrolyte composition of blood is directly dependent on the timely treatment of the patient to the doctor, correct anamnesis, complete and comprehensive diagnosis, adequate treatment, chosen individually in each case.
Do not forget about the prevention of hypokalemia.Daily intake of the necessary amount of fruits and vegetables will restore the necessary supply of potassium.Foods containing high amounts of potassium include: potatoes, cabbage, lettuce, spinach, bananas, dried apricots, raisins, nuts (walnuts, pine, almond).
It must be remembered that the reduction of potassium in the blood can lead to serious consequences only in the absence of treatment.A healthy lifestyle, nutrition, advice from a qualified specialist of hypokalemia protect and preserve health.