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Medical Forum / General / Cardiology / September 2005

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Question: Urine Potassium levels

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Jason - 30 Sep 2005 18:58 GMT
I'm reading a book related to understanding blood test results.
What's the "expected range" or "reference" for
Urine Potassium?

Thanks in advance

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Robert - 30 Sep 2005 20:59 GMT
> I'm reading a book related to understanding blood test results.
> What's the "expected range" or "reference" for
> Urine Potassium?
>
> Thanks in advance

Seeing that it can be related to SMC in terms of diuretic use in K sparing
or not then I am game for it.

There use to be reference ranges for 24 hr collection specimens that were
dependent on diet and on adequate collection.
In normal individuals made hypokalemic by K deprivation K urine levels are
as low as 10-15 mmol/day.
In hyperkalemia values as high as 400 mmol/day have been noted.
Normal 60-80 mmol/day

24 hr collection are rarely done anymore.

Measurement of urine K by itself is of limited use as it reflects the
K/water ratio so in order to interpret that then the volume or the urine
osmolality or the K to creatinine ratio is used.
For random specimens usually under 20 Meq/L is K retention and over that
amount is K excretion by the kidneys.

Normal 6-8 mmol/mmol creatinine
Hypokalemia 1-1.5 mmol/mmol/creatinine
Hyperkalemia 10-15 mmol/mmol/creatinine

The fractional excretion of K Fe(K) can be used in which simultaneous urine
and blood levels of K can be used in a formula but then it would have to be
evaluated using a nomogram.

One can also use the sodium/potassium ration as an index for
mineralcorticoid action in the presence of a normal intake of sodium.

Finally you have the TTKG or the Transtubular K Gradient which looks at the
= Kurine/(urine/plasma)osmolality/Kplasma

In hypokalemia the TTKG is under 2 and in hyperkalemia it is greater than
10.

The common thread in all of this is that K is under homeostatic control and
if one is hypokalemic then an appropriated urine response should follow and
so forth with hyperkalemia.
If it does not match that response then it is a clue to the origin of the
abnormality. There is no "normal" range because of homeostasis.

One needs to order a urine K when investigating a low or high K blood level.
If you have a low K blood level then your urine should be conserving or
retaining urine K leading to a low urine K level.
If you have a high blood K level then the urine should be high in K
indicating excretion.

A person with a low blood K and a high K urine level indicates inappropriate
K handling as with the action of a diuretic or abnormal hormonal levels.
Jason - 30 Sep 2005 22:39 GMT
> > I'm reading a book related to understanding blood test results.
> > What's the "expected range" or "reference" for
[quoted text clipped - 51 lines]
> A person with a low blood K and a high K urine level indicates inappropriate
> K handling as with the action of a diuretic or abnormal hormonal levels.

Thanks for your post. I made a hard copy and will study it later. I now
understand why the doctor that wrote the book did not state the "expected
range" in relation to K like he did with many other subjects such as
Glucose and calcium. Keep up the great work.
Jason

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