Potassium Update

As an essential mineral and major electrolyte, potassium influences several bodily functions, including nerve transmission, blood pressure regulation, acid-base balance, and muscle contraction.

Dietary intake, nutritional status, kidney function, comorbidities, and medication use, especially diuretics, can significantly affect serum potassium levels which must be maintained within a fairly narrow range. 

Low serum potassium can contribute to hypertension, ventricular fibrillation, and heart failure, and may be exacerbated by hypomagnesemia and stress.

Elevated serum potassium may be caused by renal insufficiency and can be fatal.

Maintaining serum potassium between 4.0 and 5.0 mEq/L (mmol/L) and monitoring levels regularly in those with renal insufficiency, hypertension, diabetes, heart failure, and diuretic use would be prudent and help support optimal health.

Updating the ODX optimal range to 4.0 - 5.0 mEq/L will allow clinicians to investigate trends toward hypokalemia or hyperkalemia, especially in individuals with associated comorbidities.

Please note:

Assessment of potassium status is complex and must consider comorbidities, renal function, medication use, stress level, and nutrition status. Levels should be closely monitored in those with acute pathology, while above or below-optimal trends should be evaluated further in healthy individuals.

References

Kubzansky, Laura D, and Gail K Adler. “Aldosterone: a forgotten mediator of the relationship between psychological stress and heart disease.” Neuroscience and biobehavioral reviews vol. 34,1 (2010): 80-6. doi:10.1016/j.neubiorev.2009.07.005

Macdonald, John E, and Allan D Struthers. “What is the optimal serum potassium level in cardiovascular patients?.” Journal of the American College of Cardiology vol. 43,2 (2004): 155-61. doi:10.1016/j.jacc.2003.06.021

Pagana, Kathleen Deska, et al. Mosby's Diagnostic and Laboratory Test Reference. 15th ed., Mosby, 2021.

Palaka, Eirini et al. “Associations between serum potassium and adverse clinical outcomes: A systematic literature review.” International journal of clinical practice vol. 74,1 (2020): e13421. doi:10.1111/ijcp.13421

Sur, Moushumi. and Shamim S. Mohiuddin. “Potassium.” StatPearls, StatPearls Publishing, 21 December 2021