Causes of Hypokalemia

Transcellular Shifts:

 - Alkalosis, Increased plasma insulin (treatment of diabetic ketoacidosis), ß-Adrenergic agonists, Hypokalemic periodic paralysis (congenital), Thyrotoxic hypokalemic periodic paralysis

Decreased Intake:

 - Fasting, Alcoholism (worsened by hypomagnesemia), Eating disorders

GI Losses:

 - Vomiting* , nasogastric suction, Diarrhea* (including laxative, enema abuse), Malabsorption, Ureterosigmoidostomy, Enteric fistula, Villous adenoma

Renal Losses:

 - Diuretics (carbonic anhydrase inhibitors, loop diuretics, and thiazide-like diuretics), Primary hyperaldosteronism, Secondary hyperaldosteronism, Licorice ingestion, Excessive use of chewing tobacco, Renal tubular acidosis, Postobstructive diuresis, Osmotic diuresis, Bartter's syndrome (mimics loop diuretic use), Gitelman's syndrome (mimics thiazide diuretic use), Apparent mineralocorticoid excess and related syndromes (Conn's, Liddle's), Drugs and toxins (aminoglycosides, echinocandins, carbenicillin, penicillins, amphotericin B, levodopa, lithium, thallium, cesium, barium, toluene, theophylline, chloroquine, steroids, etc.)

Sweat Loss:

 - Heavy exercise, Heat stroke, Fever

Other:

 - Hypomagnesemia, Acute leukemia and lymphomas, IV hyperalimentation, Recovery from megaloblastic anemia, Hypothermia (accidental or induced)



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