Excessive potassium excretion

Introduction Excessive potassium excretion in the kidney is common in long-term use of diuretics or excessive use. Long-term use of thiazide diuretics may lead to water and electrolyte imbalance, resulting in low sodium, low chlorine and hypokalemia.

Cause

The ability of the kidney to excrete potassium is extremely strong and fast, and about 90% of the potassium ingested can be excreted from the urine within 4 hours. Excretion is carried out in the form of Na+-K+ exchange in renal tubular epithelial cells. The characteristic of potassium excretion is to eat more rows, eat less and less, and not to eat, that is, the potassium retention capacity of the kidney is lower than that of sodium retention.

an examination

Related inspection

Blood test urine routine renal function test urine analysis

Pass urine test and blood test. Serum potassium <3.5 mmol/L for hypokalemia and <2.5 mmol/L for severe hypokalemia. There is no potassium in normal urine or only a small amount of potassium.

Differential diagnosis

Hyperkalemia: Hyperkalemia refers to a potassium concentration of >5.5 mmol/L. Causes: too much into the body: a large number of imported blood, intravenous KCl or renal failure and excessive intake of potassium-containing foods; difficulty in excretion: kidney failure, shock or due to long-term use of aldosterone antagonists such as spironolactone, Can affect the excretion of K+; intracellular and extracellular transfer: acidosis inhibits K+-Na+ pump, stimulates excessive insulin secretion, makes K+ shift, large area burn, muscle crush syndrome destroys muscle tissue, K+ is released into blood .

Hypokalemia: A group of syndromes caused by excessive potassium in the whole or normal blood potassium, but the potassium is abnormally distributed inside and outside the cell, causing hypokalemia. Serum potassium <3.5 mmol/L for hypokalemia and <2.5 mmol/L for severe hypokalemia. Causes: Insufficient intake: such as fasting or inability to eat, chronic wasting diseases can reduce blood potassium concentration; increased discharge: such as vomiting and diarrhea, gastrointestinal decompression, diuretic does not supplement potassium, long-term use of adrenocortical hormone; Potassium transfer to the cells: such as burn healing period, glucose and insulin injection, alkalosis and so on. Pass urine test and blood test. Serum potassium <3.5 mmol/L for hypokalemia and <2.5 mmol/L for severe hypokalemia. There is no potassium in normal urine or only a small amount of potassium.

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