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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.

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Presentation on theme: "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."— Presentation transcript:

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 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: journals.permissions@oupjournals.org

2 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: journals.permissions@oupjournals.org

3 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: journals.permissions@oupjournals.org

4 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: journals.permissions@oupjournals.org

5 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: journals.permissions@oupjournals.org

6 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: journals.permissions@oupjournals.org

7 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: journals.permissions@oupjournals.org

8 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: journals.permissions@oupjournals.org

9 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: journals.permissions@oupjournals.org

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