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Normal serum potassium levels are considered to lie roughly between 3.6 and 5.0 mmol/L. 1 This compartmentalization depends on active transport through the cell membrane by a sodium-potassium pump, which maintains an intracellular cation ratio of 1:10. Of the total body potassium content (about 3500 mmol ), 90% is sequestered within cells. This article reviews contemporary thinking on potassium in clinical practice. The multifactorial and interactive mechanisms that are stimulated by hypertension and even more so by heart failure, which mandate the introduction of drugs that disrupt electrolyte homeostasis, emphasize the serious role of potassium. The current lack of consensus on how to prevent and treat hypokalemia has led to the neglect of a wide range of situations in which increasing potassium intake might help prevent sequelae of cardiovascular disease. Therefore, many clinicians may not attempt to remedy subnormal potassium levels except in high-risk patients. Another reason is the practical difficulty of achieving and maintaining optimal potassium levels. One reason may be the inconvenience of accurately measuring total body potassium, which entails a 24-hour urinary collection rather than a rapid laboratory serum measurement. Although it has long been established that the maintenance of normal serum potassium is essential in reducing the risk of life-threatening cardiac arrhythmias, accumulating evidence suggests that the increased intake of potassium can also lower blood pressure and reduce the risk of stroke.įew clinicians attempt to monitor and augment potassium stores on a routine basis. In recent years, studies of the potential pathogenetic role of potassium deficiency in various medical conditions have underscored the importance of preventing or correcting this deficiency.

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