an approach to the patient with severe hypokalaemia: the potassium quiz by j.h.m. groeneveld, y.w.j....

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An approach to the patient with severe hypokalaemia: the potassium quiz by J.H.M. Groeneveld, Y.W.J. Sijpkens, S.-H. Lin, M.R. Davids, and M.L. Halperin QJM Volume 98(4):305-316 March 21, 2005 The Author 2005. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: [email protected]

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Page 1: An approach to the patient with severe hypokalaemia: the potassium quiz by J.H.M. Groeneveld, Y.W.J. Sijpkens, S.-H. Lin, M.R. Davids, and M.L. Halperin

An approach to the patient with severe hypokalaemia: the potassium quiz

by J.H.M. Groeneveld, Y.W.J. Sijpkens, S.-H. Lin, M.R. Davids, and M.L. Halperin

QJMVolume 98(4):305-316

March 21, 2005

The Author 2005. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: [email protected]

Page 2: An approach to the patient with severe hypokalaemia: the potassium quiz by J.H.M. Groeneveld, Y.W.J. Sijpkens, S.-H. Lin, M.R. Davids, and M.L. Halperin

Initial steps in the patient with a very low PK.

J.H.M. Groeneveld et al. QJM 2005;98:305-316

The Author 2005. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: [email protected]

Page 3: An approach to the patient with severe hypokalaemia: the potassium quiz by J.H.M. Groeneveld, Y.W.J. Sijpkens, S.-H. Lin, M.R. Davids, and M.L. Halperin

Creation of a more negative voltage in cells.

J.H.M. Groeneveld et al. QJM 2005;98:305-316

The Author 2005. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: [email protected]

Page 4: An approach to the patient with severe hypokalaemia: the potassium quiz by J.H.M. Groeneveld, Y.W.J. Sijpkens, S.-H. Lin, M.R. Davids, and M.L. Halperin

Approach to the patient with low K+ excretion.

J.H.M. Groeneveld et al. QJM 2005;98:305-316

The Author 2005. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: [email protected]

Page 5: An approach to the patient with severe hypokalaemia: the potassium quiz by J.H.M. Groeneveld, Y.W.J. Sijpkens, S.-H. Lin, M.R. Davids, and M.L. Halperin

Approach to the patient with high K+ excretion.

J.H.M. Groeneveld et al. QJM 2005;98:305-316

The Author 2005. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: [email protected]

Page 6: An approach to the patient with severe hypokalaemia: the potassium quiz by J.H.M. Groeneveld, Y.W.J. Sijpkens, S.-H. Lin, M.R. Davids, and M.L. Halperin

Components of K+ excretion in the terminal CCD. The barrel shaped structures represent the terminal CCD. Reabsorbing Na+ faster than Cl− in the CCD creates the lumen negative voltage

that drives the net secretion of K+.

J.H.M. Groeneveld et al. QJM 2005;98:305-316

The Author 2005. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: [email protected]

Page 7: An approach to the patient with severe hypokalaemia: the potassium quiz by J.H.M. Groeneveld, Y.W.J. Sijpkens, S.-H. Lin, M.R. Davids, and M.L. Halperin

Plasma renin and aldosterone in the syndromes of mineralocorticoid excess.

J.H.M. Groeneveld et al. QJM 2005;98:305-316

The Author 2005. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: [email protected]

Page 8: An approach to the patient with severe hypokalaemia: the potassium quiz by J.H.M. Groeneveld, Y.W.J. Sijpkens, S.-H. Lin, M.R. Davids, and M.L. Halperin

Indirect loss of NaHCO3 in glue sniffing.

J.H.M. Groeneveld et al. QJM 2005;98:305-316

The Author 2005. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: [email protected]

Page 9: An approach to the patient with severe hypokalaemia: the potassium quiz by J.H.M. Groeneveld, Y.W.J. Sijpkens, S.-H. Lin, M.R. Davids, and M.L. Halperin

Non-invasive estimate of the flow rate in the terminal CCD. The barrel-shaped structure represents the CCD. When ADH acts, the Posm and the osmolality in the luminal fluid of the CCD

are equal (represented as 300 mOsm/kg H2O for easy calculation).

J.H.M. Groeneveld et al. QJM 2005;98:305-316

The Author 2005. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: [email protected]