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What Causes Low Potassium Levels?
Question: Critically low potassium. Was down to 1.9 but now almost normal taking 80 MEQ potassium a day. Enlarged spleen. Slightly low RBC's and slightly elevated WBC's. CT Scan also showed kidney stones, but they are not blocking anything. One blood test "The XXXXXXX Renin Ratio is elevated but Aldosterone itself is not significantly
elevated. " CT scan showed adrenals are normal.
Unknown etiology on spleen. I'm just hoping for other ideas. The low potassium issue has been going on for several years.
elevated. " CT scan showed adrenals are normal.
Unknown etiology on spleen. I'm just hoping for other ideas. The low potassium issue has been going on for several years.
Brief Answer:
Low potassium levels.
Detailed Answer:
Good day,
Noted your concerns.
There are number of reasons why Potassium can be low.
I must say that Potassium has to be corrected before checking Aldosterone, otherwise, aldosterone values tend to be false. Again posture of the patient is important when we check Aldosterone.
What is the renin levels?
We need to do a 24 hour urine potassium and creatinine.. This will give a clue if you are losing potassium in urine or elsewhere.
Cushing's syndrome is yet another cause of low potassium. And there are some renal tubule defects which can cause low potassium and magnesium ( GITTLEMAN Syndrome).
What about Magnesium and bicarbonate levels? Any tests done ??
It is important to visit an Endocrinologist to further investigate his condition.
Spleen may need to be investigated separately by a hematologist.
Regards
Binu
Low potassium levels.
Detailed Answer:
Good day,
Noted your concerns.
There are number of reasons why Potassium can be low.
I must say that Potassium has to be corrected before checking Aldosterone, otherwise, aldosterone values tend to be false. Again posture of the patient is important when we check Aldosterone.
What is the renin levels?
We need to do a 24 hour urine potassium and creatinine.. This will give a clue if you are losing potassium in urine or elsewhere.
Cushing's syndrome is yet another cause of low potassium. And there are some renal tubule defects which can cause low potassium and magnesium ( GITTLEMAN Syndrome).
What about Magnesium and bicarbonate levels? Any tests done ??
It is important to visit an Endocrinologist to further investigate his condition.
Spleen may need to be investigated separately by a hematologist.
Regards
Binu
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
no bicarbonate tests done
Current potassium is at 3.5.
CREATININE 0.5 mg/dL (blood/substance)
CREATININE 2090 mg/24hr (urine)
SODIUM 414 mmol/24hr
ALDOSTERONE 14.33 ug/24 hr
MAGNESIUM 1.87 mg/d
July 2014 when potassium at 3.5
ALDOSTERONE 15.6 ng/dL
ALDOSTERONE/RENIN >104.0
RENIN <0.15 ng/mL/hr
May 2014 when potassium at 2.9
ALDOSTERONE 10.8 ng/dL
ALDOSTERONE/RENIN 45.0
RENIN 0.24 ng/mL/hr
Current potassium is at 3.5.
CREATININE 0.5 mg/dL (blood/substance)
CREATININE 2090 mg/24hr (urine)
SODIUM 414 mmol/24hr
ALDOSTERONE 14.33 ug/24 hr
MAGNESIUM 1.87 mg/d
July 2014 when potassium at 3.5
ALDOSTERONE 15.6 ng/dL
ALDOSTERONE/RENIN >104.0
RENIN <0.15 ng/mL/hr
May 2014 when potassium at 2.9
ALDOSTERONE 10.8 ng/dL
ALDOSTERONE/RENIN 45.0
RENIN 0.24 ng/mL/hr
Brief Answer:
Suggestive of Primary hyperaldosterinism
Detailed Answer:
July 2014 when potassium at 3.5
ALDOSTERONE 15.6 ng/dL
ALDOSTERONE/RENIN >104.0
RENIN <0.15 ng/mL/hr
The above values shows low normal Potassium. Aldosterone is elevated and Renin is suppressed and Aldo/Renin ratio is elevated. This is quite suggestive of primary hyperaldosteronism. DID YOU MEET AN ENDORINOLOGIST ??
The next step would be a confirmatory test like Saline Loading test. This will guide further evaluation.
How is your blood pressure?? Are you on any medications?
Suggestive of Primary hyperaldosterinism
Detailed Answer:
July 2014 when potassium at 3.5
ALDOSTERONE 15.6 ng/dL
ALDOSTERONE/RENIN >104.0
RENIN <0.15 ng/mL/hr
The above values shows low normal Potassium. Aldosterone is elevated and Renin is suppressed and Aldo/Renin ratio is elevated. This is quite suggestive of primary hyperaldosteronism. DID YOU MEET AN ENDORINOLOGIST ??
The next step would be a confirmatory test like Saline Loading test. This will guide further evaluation.
How is your blood pressure?? Are you on any medications?
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
A nephrologist was consulted. But the medical plan I go through dropped the ball on the consult. None of my results had been forwarded to him since July 2014.
I thought I had mentioned meds. High blood pressure for a years now. Three different meds. Taken off of hctz when the potassium issue started. Still on Lisinopril, atenolol and amlodipine besylate.
I'll bring up the Saline Loading Test. I really appreciate your responses. Thank you.
I thought I had mentioned meds. High blood pressure for a years now. Three different meds. Taken off of hctz when the potassium issue started. Still on Lisinopril, atenolol and amlodipine besylate.
I'll bring up the Saline Loading Test. I really appreciate your responses. Thank you.
Brief Answer:
Aldactone
Detailed Answer:
Thanks for the reply. Once we complete saline loading test, please demand ( if your doc doesn't wilfully refer you ) for an endocrine consultation. This is no more a nephrologists Job now. You need an expert endocrine follow up.
Besides , once you ccomplete saline loading, you need to be started on Aldactone as an anti hypertensive agent. That would successfully bring up your potassium levels as well as will treat hypertension effectively.
Aldactone
Detailed Answer:
Thanks for the reply. Once we complete saline loading test, please demand ( if your doc doesn't wilfully refer you ) for an endocrine consultation. This is no more a nephrologists Job now. You need an expert endocrine follow up.
Besides , once you ccomplete saline loading, you need to be started on Aldactone as an anti hypertensive agent. That would successfully bring up your potassium levels as well as will treat hypertension effectively.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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