Correction of Serum Potassium Level in Hypokalaemic Patients with Hypomagnesaemia and Normomagnesaemia

Abstract

Objective: To determine the extent of increase in potassium level after intravenous infusion of potassium chloride in hypokalaemic patients with hypomagnesaemia and normomagnesaemia and to overview the impact of different concentrations and dilutions of potassium chloride infusion for rapid correction of hypokalaemia.
 Methods: A prospective, cohort study was conducted in Abbasi Shaheed Hospital, Karachi from January to March 2016. Convenience sampling was done, 46 patients were included who had a Serum Potassium level less than 3.5 meq/L at the time of admission to the hospital. Protocols of potassium chloride infusion such as such as 20 mEq/200 ml, 30 mEq/300 ml, 40 mEq/400 ml and 50 mEq/500 ml were given to three groups of hypokalaemic patients having hypomagnesaemia, normomagnesaemia and hypermagnesaemia to figure out the correlation of potassium correction with serum magnesium level. The pre and post-infusion serum potassium levels were checked along with the outcome of the extent of increase in potassium levels.
 Results: For 46 patients (mean age 60 ± 3 (r= 21-96 years), the mean pre-infusion serum potassium and magnesium levels were found to be 3.12 ± 0.04 (r= 2.30-3.5) mmol/L and 0.81 ± 0.03 (r= 0.52- 1.58) mmol/L respectively. The difference in the pre/post-infusion serum potassium levels in hypokalaemic patients with hypomagnesemia (n= 46) was not found be significant (p>0.05) whereas the pre/post-infusion serum potassium level was significant (p<0.05) in hypokalaemic patients with normomagnesaemia or hypermagnesaemia.
 Conclusion: Serum magnesium level needs to be concurrently monitored and corrected in mild to moderate hypokalaemic patients as low magnesium levels were found to have profound effect on serum potassium level in patients receiving potassium supplement for correction of potassium level back to normal.