Potassium is one of the most abundant metals on the earth. An essential electrolyte, potassium comes in several different compounds called salt-forms, according to "Williams Textbook of Endocrinology." The most commonly used potassium supplements used in clinical settings are potassium citrate, potassium bicarbonate and potassium chloride.
Potassium supplementation should be considered when the plasma potassium level drops below normal. Please consult your health care provider before taking any supplement.
Potassium Citrate
Most commonly used potassium salt is potassium citrate. Available in liquid or wax-matrix tablet, potassium citrate is more frequently used in the tablet form due to the unpalatable taste of the liquid form, according to "Cecil Medicine." Tablets are available as 5 milliEquivants, mEq and 10 mEq.
"Williams Textbook of Endocrinology" notes that in malabsorption conditions, such as Crohn's, liquid-form potassium citrate is applied because it is better absorbed.
"Brenner and Rector's The Kidney" states that potassium citrate has been shown to reduce the formation of calcium oxalate kidney stones and to treat renal tubular acidosis. Side effects are possible increase in pH of the blood. Because citrate is a base, metabolic alkalosis can result when taking excessive amounts of potassium citrate or in kidney failure. A good alternative to counter the alkalosis is potassium chloride.
Potassium Bicarbonate
"Rosen's Emergency Medicine" notes that potassium bicarbonate is used to treat metabolic acidosis states, especially renal tubular acidosis. In patients with renal insufficiency, the levels of bicarbonate should be closely monitored.
"Brenner and Rector's The Kidney" indicates that potassium bicarbonate requires more dosing per day than potassium citrate. The dosing increases are due to potassium bicarbonate's propensity to be metabolized into bicarbonate in the liver. A side effect of potassium bicarbonate is that it leads to urinary citrate excretion. If the citrate excretion becomes excessive then the potassium treatment needs to be switched to potassium citrate.
Potassium Chloride
"Williams Textbook of Endocrinology" notes that potassium chloride is used more commonly in treatment of metabolic alkalosis than other formations. In fact, potassium chloride is the default salt of choice in most patients, especially those with metabolic alkalosis related to kidney chloride loss and severe vomiting. Another advantage to potassium chloride is that it raises the blood levels of potassium faster than potassium bicarbonate.
References
- "Rosen's Emergency Medicine" 7th ed.; John Marx, M.D., et al.; 2009
- "Brenner and Rector's The Kidney" 8th ed.; Barry Brenner, M.D.; 2007
- "Williams Textbook of Endocrinology" 11th ed.; Henry Kronenberg, M.D., et al.; 2008
- "Cecil Medicine" 23rd ed.; Lee Goldman, M.D. and Dennis Ausiello, M.D.; 2008
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