Analysis Of The Causes Of 482 Cases Of Hospitalized Patients With Hypokalemia In Department Of Endocrinology Of The First Affiliated Hospital Of Dalian Medical University From 2010 To 2016

Objective:Retrospective analysis of the causes of hypokalemia,clinical manifestations of admission,treatment and prognosis in the department of endocrinology in our hospital during the past 6 years,to understand the clinical characteristics of patients with hypokalemia,In order to improve the level of diagnosis and treatment of hypokalemia.Methods:Retrospective analysis of 482 cases of patients in the department of endocrinology in our hospital with definite diagnosis of hypokalemia and complete data from 2010.06.01-2016.05.31 by medical record inquiry system,eliminate accidental and transient factors,the clinical data of each patient were collected,including sex,age,primary disease,clinical manifestation,auxiliary examination,the causes of hypokalemia and the proportion of various causes.Data analysis using SPSS22.0 software,the data of all continuous variables are expressed as mean plus or minus standard deviation(x±s),variance analysis(F)was used for comparison between groups,enumeration data are expressed as percentage,chi-square test(?2)was used for comparison between groups.Results:1.In the past 6 years the age range of the patients with hypokalemia in endocrinology department was 12-93,and the average age was 53.01±17.65 years.2.There were 119 patients(24.69%)under the 40 years old,and 40-60 years old for 181 cases(37.55%),over 60 years old for 182 cases(37.76%).Obviously,the endocrinology hypokalemia patients were mainly over 40 years old.The number of male patients was 234 cases(48.55%),female 248 cases(51.45%),the ratio of male to female was 0.94:1.3.According to the degree of hypokalemia,mild hypokalemia(serum potassium 3.0-3.5mmol/l,excluding 3.5mmol/l)in 279 cases(57.88%),among them,169 cases(60.57%)were mainly caused by diabetes mellitus,followed by gastrointestinal causes and diuretics.Moderate hypokalemia(serum potassium 2.5-3.0mmol/l,excluding 3.0mmol/l)in 122 cases(25.31%).Severe hypokalemia(serum potassium<2.5mmol/l)in 81 cases(16.81%).Obviously,mild hypokalemia accounted for the majority of patients.4.Distribution of mild,moderate and severe hypokalemia in different etiology of endocrine related hypokalemia.Diabetic mellitus patients with mild hypokalemia in 169 cases(75.45%),moderate hypokalemia in 46 cases(20.54%),severe hypokalemia in 9 cases(4.02%).Primary aldosteronism patients with mild hypokalemia in 10 cases(25.64%),moderate hypokalemia in 19 cases(48.72%),severe hypokalemia in 10 cases(25.64%).Thyrotoxic hypokalemic periodic paralysis patients with mild hypokalemia in 4 cases(15.38%),moderate hypokalemia in 6 cases(23.08%),severe hypokalemia in 16 cases(61.54%).Cushing syndrome patients with mild,moderate and severe hypokalemia were 2 cases,6 cases,4 cases.5.Distribution of mild,moderate and severe hypokalemia in different etiology of non endocrine related hypokalemia.Inadequate intake and gastrointestinal loss hypokalem-ia patients with mild hypokalemia in 65 cases(65.22%),moderate hypokalemia in 17 cases(24.64%),severe hypokalemia in 7 cases(10.14%).Drug-induced hypokalemia patients with mild hypokalemia in 40 cases(60.61%),moderate hypokalemia in 17 cases(25.75%),severe hypokalemia in 9 cases(13.64%).Undetermined etiology patients with mild,moderate and severe hypokalemia were 8 cases,6 cases,11 cases.Primary hypokalemic periodic paralysis patients with mild,moderate and severe hypokalemia were 1 cases,3 cases,7 cases.Gitelman syndrome patients with mild,moderate and severe hypokalemia were 0 cases,2 cases,2 cases.3 patients with renal tubular acidosis and the other 3 patients with batter syndrome had severe hypokalemia.6.According to the clinical manifestations of admission in patients with hypokalemia,with the primary symptom in 263 cases(54.56%),with the symptoms of weakness in 94 cases(19.50%),with gastrointestinal symptoms as the main manifestation(such as anorexia,nausea,vomiting,diarrhea)in 35 cases(7.26%),with intermittent limb weakness as the main manifestation in 36 cases(7.47%),with dizziness,headache as main manifestation in 11 cases(2.28%),with limbs spasm symptom in 7 cases(1.45%).Conclusions:1.The common causes of endocrine associated hypokalemia include DM,PA,THPP,CS,except for DM was mainly with mild hypokalemia,the others were mainly with moderate and severe hypokalemia.2.Non endocrine related hypokalemia common diseases are due to drugs and digestive tract factors,and mainly with mild hypokalemia,while other PHPP,RTA and BS were mainly with severe hypokalemia.3.The inpatients with hypokalemia in Department of Endocrinology were mainly mid dle-aged and elderly patients,and there was no significant difference in the proportion of men and women,and the majority of them were mild hypokalemia...