Potassium deficiency, manifested as hypokaliemia, is much less common. Again, it can be caused by diuretic drugs, such as thiazides, which increase potassium excretion. It can also occur spontaneously. Sometimes the diseased kidneys cannot retain the potassium your body needs.
Unlike hyperkaliemia, hypokaliemia presents with clear symptoms, including muscle cramps and weakness, which may progress to paralysis. Cardiac rhythm disturbances are often the first manifestation of potassium deficiency, and can be fatal when the potassium deficiency is severe.
Serum potassium concentration below normal, namely less than 3.4 mEq per liter, confirms the diagnosis. Often this also may be associated with an increase in serum bicarbonate concentration, that is, alkalosis.
Treatment of potassium deficiency is simple: oral potassium supplements, such as potassium chloride or potassium bicarbonate. Potassium preparations for oral use are designed so that potassium chloride does not come into contact with the small intestine, where it's known to cause ulcers. The amount of potassium needed to correct and/or prevent deficiency varies; 25 mEq is a good starting dose, but it is usually not enough. Typically the deficiency amounts to 300 mEq or more, so 100 mEq a day would be a good dose. It must be administered slowly to avoid a dangerous rise in serum potassium concentration.
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