Pediatric Hypokalemia Differential Diagnoses

Updated: Jan 06, 2021
  • Author: Michael J Verive, MD, FAAP; Chief Editor: Timothy E Corden, MD  more...
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Diagnostic Considerations

Important considerations

Adequately communicate the risks of treatment to the caregivers and/or patient.

Monitor patients receiving potassium supplementation for complications, especially patients with renal failure or patients receiving potassium-sparing diuretics or angiotensin-converting enzyme inhibitors.

Follow serum potassium and other electrolyte concentrations during or after therapy.

Ensure adequate precautions against treating a patient on the basis of a low serum potassium value that is false because of a sampling or laboratory error. However, do not fail to treat a patient with symptoms of actual hypokalemia because of an elevated serum potassium value that is false because of a sampling or laboratory error.

Other considerations

Pseudohypokalemia may be seen with sampling errors, particularly if a blood sample is taken upstream of an infusion of saline, dextrose, or other fluids that contain little or no potassium. Clues to sampling errors include other serum level abnormalities that reflect sampling of a mixture of blood and the fluid that is infused. Additionally, the new onset of hypokalemia in otherwise stable patients without known risk factors may reflect the use of different equipment/methods used for blood analysis, and this diagnosis should be confirmed using alternative methods prior to initiating treatment.

Differential Diagnoses