Paradoxical Hyperkalemia In Dka

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Hyperkalemia In Diabetic Ketoacidosis.

Abstract Patients with diabetic ketoacidosis tend to have somewhat elevated serum K+ concentrations despite decreased body K+ content. The hyperkalemia was previously attributed mainly to acidemia. However, recent studies have suggested that "organic acidemias" (such as that produced by infusing beta-hydroxybutyric acid) may not cause hyperkalemia. To learn which, if any, routinely measured biochemical indices might correlate with the finding of hyperkalemia in diabetic ketoacidosis, we analyzed the initial pre-treatment values in 131 episodes in 91 patients. Serum K+ correlated independently and significantly (p less than 0.001) with blood pH (r = -0.39), serum urea N (r = 0.38) and the anion gap (r = 0.41). The mean serum K+ among the men was 5.55 mmol/l, significantly higher than among the women, 5.09 mmol/l (p less than 0.005). Twelve of the 16 patients with serum K+ greater than or equal to 6.5 mmol/l were men, as were all eight patients with serum K+ greater than or equal to 7.0 mmol/l. Those differences paralleled a significantly higher mean serum urea N concentration among the men (15.1 mmol/l) than the women (11.2 mmol/l, p less than 0.01). The greater tendency to hyperkal Continue reading >>

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Popular Questions

  1. crush1staid - 01/17/10 19:33

    well u know half the answer , there is shift from intra to extra cellular ,thus the patient will have Hyper K and when we treat DKA we MUST give the maintance of K bcz insulin will shift K to inra cellular.
    If not giving K with tx then we will produce Hypo K .
    In ICU treating DKA ,K started after making sure pt is urinating.
    I hope this will help.

  2. studyin4ck - 01/18/10 04:29

    so is it right to say total body pottasium is decreased but serum potassium is increased.

  3. eurogirl - 01/19/10 09:40

    You are right guest123, this is the thing!

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