Renal potassium losses

Hypotensive or normotensive

• acidosis: DKA, RTA : distal RTAs (type I) > proximal RTAs (type II)
• alkalosis: diuretics (thiazide >loop), vomiting/NGT drainage (via 2° hyperaldosteronism)
• Bartter’s syndrome (loop of Henle dysfxn→ furosemide-like effect; JASN 2017;28:2540)
• Gitelman’s syndrome (DCT dysfxn→ thiazide-like effect (KI 2017;91:24)
• drugs: acetaminophen overdose, PCN, gent., ampho, foscarnet, cisplatin, ifosfamide
• ↓ Mg: less Mg to inhibit principal cell ROMK channel, ∴ ↑ K secretion (JASN 2010;21:2109)

Hypertensive: mineralocorticoid excess

• 1° hyperaldosteronism
  • (eg, Conn syndrome, glucocorticoid-remediable aldosteronism)
• 2° hyperaldosteronism (eg, renovascular disease, renin-secreting tumor)
• Nonaldosterone mineralocorticoid
  • (eg, Cushing’s, Liddle , exogenous, licorice)
  • Liddle’s syndrome ↑ ENaC