A common treatment modality for hypokalemia is intravenous potassium replacement; especially in the setting of critically low values (<2.5).

When replacing with intravenous fluid mixtures; dextrose should be avoided as a base solution.

WHY? The use of dextrose, will increase blood glucose levels and drive up endogenous insulin production; thereby further lowering K+ levels as insulin increases intra-cellular uptake. 

REFERENCES

  1. Li T, Vijayan A. Insulin for the treatment of hyperkalemia: a double-edged sword? Clinical Kidney Journal. 2014;7(3):239-241. doi:10.1093/ckj/sfu049. 

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