Old Rule of
10 mEq of potassium is required for each 0.10 mEq/L drop in serum
10 mEq of potassium (IV/ oral) is required for each 0.13 mEq/L (mean
value for oral and IV). decline in serum [K+] from the target level.
IV: 10 meq --> 0.14 mEq/L mean change. Oral: 10 meq --> 0.12 mEq/L
Aboujamous H. et al. Evaluation of the Change in Serum Potassium Levels
after Potassium Administration. J Clin Nephrol Ren Care 2016, 2:013.
Every 10 mEq of potassium increased serum potassium 0.13 mEq/L.
Similar dose responses were seen whether IV or PO potassium was
This study supports the common practice of administering 10
mEq of potassium for every 0.1 mEq/L desired increase in serum potassium.
It takes a significant loss in potassium stores to see a drop in
serum potassium level (i.e., the extracellular space) due to
this large amount of potassium in the intracellular space that
helps to compensate for any loss.
Severe consequences of hypokalemia include cardiac arrhythmias,
rhabdomyolysis, and muscle weakness that leads to respiratory
depression or ileus. Chronic hypokalemia can cause increased
ammoniagenesis, urinary concentration defects, polyuria,
hypertension, acid base disorders, and hyperglycemia.
In examining the effect of BMI on the level of potassium
repletion achieved per 10 mEq of potassium administered, the
intravenous group had an increase in serum potassium ranging
from 0.10 to 0.17 mEq/L per 10 mEq administered while patients
that received oral potassium had a change in potassium that
ranged from 0.12 to 0.13 mEq/L per 10 mEq with no discernable
pattern across different BMI classifications.
The results further reveal that intravenous potassium appears to
impact serum potassium levels similarly to the impact of oral
potassium. Specifically, intravenous and oral potassium
administration caused a mean 0.14 and 0.12 mEq/L increase in
serum potassium level per 10 mEq administered, respectively.
There is no data to suggest that the degree of baseline hypokalemia will
exponentially increase the amount of repletion necessary. Therefore, the
lack of representation of patients with baseline moderate or severe
hypokalemia is not thought to be a limitation to allowing the results of the
study to be applied to patients with all degrees of hypokalemia.
Aboujamous et al. Evaluation of the Change in Serum Potassium Levels after
Potassium Administration. J Clin Nephrol Ren Care 2016, 2:013,
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