Approach to Hypokalemia: Diagnosis and Treatment

All causes of hypokalemia can be divided into 3 big groups:

  • Decreased intake (unlikely to be a sole cause)
  • Intracellular shift
  • External loss (GI or renal)

A step-by-step approach to diagnosis of hypokalemia

Step 1: Review current medication history. Drugs that can promote hypokalemia (via intracellular shifting or increased losses/decreased intake):

  • K-deficient fluids
  • loop/thiazide diuretics
  • insulin, dextrose
  • albuterol, terbutaline and other beta agonists
  • catecholamines
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