What is the role of sodium bicarbonate measurements in the diagnosis of hypokalemia (low potassium level)?

Updated: Dec 06, 2018
  • Author: Eleanor Lederer, MD, FASN; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

A low serum bicarbonate level may suggest renal tubular acidosis, diarrhea, or the use of carbonic anhydrase inhibitors (eg, acetazolamide, topiramate). A high serum bicarbonate level is consistent with either primary or secondary hyperaldosteronism. Causes of secondary hyperaldosteronism could be exogenous prednisone therapy, vomiting, or the use of thiazide or loop diuretics. A high serum bicarbonate level is also consistent with the presence of Bartter, Gitelman, or Liddle syndrome.


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