Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis (1136 page)

   Acute acidosis (especially hyperchloremic metabolic acidosis; less with respiratory; little with metabolic acidosis due to organic acids) (e.g., diabetic ketoacidosis, lactic acidosis, acute renal failure, acute respiratory acidosis)

   Decreased insulin

   Beta-adrenergic blockade

   Drugs (e.g., succinylcholine, great excess of
Digitalis
, arginine infusion)

   Use of hypertonic solutions (e.g., saline, mannitol)

   Intravascular hemolysis (e.g., transfusion reaction, hemolytic anemia), rhabdomyolysis

   Rapid cellular release (e.g., crush injury, chemotherapy for leukemia or lymphoma, burns, major surgery)

   Urinary diversion

   Ureteral implants into jejunum

   In neonates—dehydration, hemolysis (e.g., cephalohematoma, intracranial hemorrhage, bruising, exchange transfusion), acute renal failure, CAH, adrenocortical insufficiency

Decreased In

   Excess renal excretion (in patients with hypokalemia, urine potassium, >25 mmol in 24 hours or >15 mmol/L implies at least a renal component)

   Osmotic diuresis of hyperglycemia (e.g., uncontrolled diabetes)

   Nephropathies