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Hypokalemia in children

Authors
Michael J Somers, MD
Avram Z Traum, MD
Section Editor
Tej K Mattoo, MD, DCH, FRCP
Deputy Editor
Melanie S Kim, MD

INTRODUCTION

Hypokalemia is defined as a serum or plasma potassium that is less than the normal value. Most reference laboratories establish the lower pediatric limit of normal serum potassium between 3 and 3.5 mEq/L. However, symptoms are unlikely to occur in most healthy children until serum potassium is below 3 mEq/L.

The etiology, clinical findings, diagnosis, evaluation, and management of pediatric hypokalemia are reviewed here. Hypokalemia in adults is discussed separately. (See "Clinical manifestations and treatment of hypokalemia in adults" and "Causes of hypokalemia in adults" and "Evaluation of the adult patient with hypokalemia".)

EPIDEMIOLOGY

Hypokalemia is relatively common among hospitalized pediatric patients, especially those who are critically ill [1-3]. In one study of 667 children cared for in a single-center pediatric intensive care unit in the United States during the calendar year 2006, 40 percent of the patients had a serum potassium level below 3.5 mEq/L [1]. This included patients with severe hypokalemia, defined as potassium level less than 2.5 mEq/L (4 percent); moderate hypokalemia, defined as potassium level 2.5 to less than 3 mEq/L (12 percent); and mild hypokalemia, defined as potassium level from 3 to less than 3.5 mEq/L (24 percent). Hypokalemia was associated with diagnoses of cardiac disease, renal failure, or shock [1].

In developing countries, severe hypokalemia (potassium level <2.5 mEq/L) is often observed in children with diarrhea and severe acute malnutrition, and is associated with an increased risk of mortality [4].

POTASSIUM BALANCE AND LEVELS

Definition — Potassium is primarily an intracellular cation with cells containing approximately 98 percent of total body potassium. Hypokalemia is defined as serum level below the normal value, which is usually defined as 3.5 mEq/L.

                                                 

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Literature review current through: Nov 2016. | This topic last updated: Mon Aug 22 00:00:00 GMT+00:00 2016.
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