High transtubular grandient hypokalemia: clinical case and a practical proposal for its approach
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Hypokalemia; Bartter Syndrome; Gitelman Syndrome; potassium; electrolytes and hypercalciuria.
Bartter Syndrome
Gitelman Syndrome

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Torres S. R, Rosselli C, Olivares C, Olivares O, Rumpf PM, Pulido Medina C. High transtubular grandient hypokalemia: clinical case and a practical proposal for its approach. Rev. Colomb. Nefrol. [Internet]. 2021 May 27 [cited 2024 Jul. 15];8(2):e498. Available from: https://revistanefrologia.org/index.php/rcn/article/view/498


Potassium is a predominantly intracelular ion involved in multiple essential functions to maintain celular homeostasis. Therefore, its variations at the plasma level are tightly regulated by the renal and endocrine systems; in addition to being affected by situations such as acidosis, changes in plasma osmolality and concentration of another electrolytes. Hypokalemia is a common electrolyte disorder in clinical practice affected by reporting excessive damage or loss. Its diagnostic approach requires a complete medical history that includes personal pathological and pharmacological history, a specific physical examination with certain conditions like patient´s blood volume and hydration status, as well as the measurement of other electrolytes at the plasma level and occasionally in urine. The thanstubuar potassium gradient is a useful tool to address posible causes. Bartter síndrome is one of the causes of elevated transtubular gradient hypokalemia. 

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