What are possible causes of decreased potassium excretion?

Updated: Apr 09, 2020
  • Author: Eleanor Lederer, MD, FASN; Chief Editor: Vecihi Batuman, MD, FASN  more...
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For decreased potassium excretion, query patients regarding a history of renal insufficiency or renal failure. In addition, elicit any history of diabetes mellitus, sickle cell disease or trait, or symptoms of lower urinary tract obstruction. These conditions predispose people to type IV renal tubular acidosis, also called hyperkalemic renal tubular acidosis. Type IV renal tubular acidosis also may accompany other tubulointerstitial disorders, such as polycystic kidney disease or amyloidosis.

Often, patients with type IV renal tubular acidosis have hyporeninemic hypoaldosteronism. [20, 21] One example is diabetes mellitus, where the relative volume overload leads to low renin.

Patients with ureteral diversion into the ileum can develop hyperkalemia due to reabsorption of secreted potassium.

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