Q: Potassium repletion is available in various preparations like potassium chloride, potassium phosphate, potassium citrate, potassium acetate or potassium gluconate. Why potassium chloride is a preferred method?


Answer:  Out of all potassium preparations, potassium chloride is preferred for two reasons. First, it raises the serum potassium concentration at a faster rate. This is due to the fact that chloride is primarily an extracellular anion and it does not enter cells, thereby it promotes maintenance of the administrated potassium in the extracellular fluid. Second, unlike potassium bicarbonate or when its precursor potassium acetate or potassium citrate are  administrated it does not cause metabolic alkalosis, which is itself a cause of hypokalemia. Potassium bicarbonate or its precursors are preferable when hypokalemia and metabolic acidosis exist together. 




Reference:

Villamil MF, Deland EC, Henney RP, Maloney JV Jr. Anion effects on cation movements during correction of potassium depletion. Am J Physiol 1975; 229:161.