Hey team:We discussed yesterday the clinical pearl that you cannot correct hypokalemia in the face of hypomagnesemia. This is useful to remember especially in ICU patients.
The question came up as to the underlying pathophysiology of this phenomenon and I am happy to provide some evidence that indeed it seems to be related to ATP! In addition it seems that hypomagnesemia itself increases potassium excretion in the ascending loop of Henle. These changes result in potassium loss in the urine that is refractory to potassiumsupplementation.
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