Potassium in Alcoholic ketoacidosis

Q: Alcoholic ketoacidosis results in? (select one)

A) hyperkalemia

B) hypokalemia

Answer: B

Unlike other conditions which produce hyperkalemia in metabolic acidosis, alcoholic ketoacidosis mostly results in hypokalemia. There are four major reasons for it.

1. Gastrointestinal loss due to vomiting or diarrhea.

2. Urinary losses due to excretion of potassium salts of ketone anions (beta-hydroxybutyrate and acetoacetate) 

3. Poor nutrition and reduced oral potassium intake.

4. In contrast to other conditions with metabolic acidosis, alcoholic ketoacidosis does not results in much potassium redistribution between intra and extracellular space.

#electrolyte

#acid-base balance

References:

1. Noor NM, Basavaraju K, Sharpstone D. Alcoholic ketoacidosis: a case report and review of the literature. Oxf Med Case Reports. 2016 Mar 3;2016(3):31-3. doi: 10.1093/omcr/omw006. PMID: 26949539; PMCID: PMC4776050.

2. McGuire LC, Cruickshank AM, Munro PT. Alcoholic ketoacidosis. Emerg Med J. 2006 Jun;23(6):417-20. doi: 10.1136/emj.2004.017590. PMID: 16714496; PMCID: PMC2564331.