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Potassium Correction Calculator

Hypokalemia & Hyperkalemia

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1 What is the Potassium Correction Calculator?

The Potassium Correction Calculator provides weight-based dosing for both hypokalaemia and hyperkalaemia management, toggled by direction. For low potassium, it calculates an IV potassium chloride replacement dose; for high potassium, it calculates the cascade of emergency treatments — calcium, insulin/dextrose, sodium bicarbonate, and kayexalate. The tool also lays out the clinical order in which hyperkalaemia treatments should be given.

2 When to use it

  • Dosing IV potassium chloride replacement for a child with confirmed hypokalaemia
  • Calculating emergency hyperkalaemia treatment doses (calcium, insulin/dextrose, bicarbonate, kayexalate) in a child with dangerous potassium elevation
  • Guiding the correct sequence of interventions when a hyperkalaemic patient has ECG changes
  • Identifying when to hold potassium replacement due to inadequate urine output
  • Prompting concurrent magnesium repletion in refractory hypokalaemia
  • Supporting further work-up of renal potassium wasting or the underlying cause of hyperkalaemia

3 Formula & method

For hypokalaemia: 'KCl 0.5 – 1 mEq/kg IV over 1–2 hours. Maximum peripheral concentration: 40 mEq/L. Maximum infusion rate: 0.5 mEq/kg/hr (peripheral) or 1 mEq/kg/hr (central, with cardiac monitoring).' For hyperkalaemia, the app calculates: dextrose 1–2 g/kg with insulin 0.1 U/kg; calcium chloride 10–20 mg/kg (max 500 mg/dose) or calcium gluconate 100 mg/kg (max 2 g/dose); sodium bicarbonate 1–2 mEq/kg; and kayexalate 1–2 g/kg/dose. The app specifies a treatment order: calcium first if ECG changes are present, then insulin/dextrose and/or salbutamol, then sodium bicarbonate if acidotic, then kayexalate/diuretic/dialysis to remove potassium from the body.

4 Frequently asked questions

What is the standard IV potassium replacement dose for hypokalaemia?

The app calculates KCl 0.5–1 mEq/kg IV given over 1–2 hours, with a maximum peripheral concentration of 40 mEq/L and a maximum infusion rate of 0.5 mEq/kg/hr peripherally (1 mEq/kg/hr centrally with cardiac monitoring).

What is given first in severe hyperkalaemia with ECG changes?

Per the app's stated order of intervention, calcium is given first when ECG changes such as peaked T waves, widened QRS, or a sine wave pattern are present, because it stabilises the myocardium.

What doses does the calculator provide for hyperkalaemia?

It calculates dextrose 1–2 g/kg with insulin 0.1 U/kg, calcium chloride 10–20 mg/kg (or calcium gluconate 100 mg/kg), sodium bicarbonate 1–2 mEq/kg, and kayexalate 1–2 g/kg/dose.

Why does the app recommend checking magnesium during potassium replacement?

It notes that concomitant magnesium replacement is essential because refractory hypokalaemia is often caused by underlying hypomagnesaemia.

When should potassium replacement be held?

The app advises holding replacement if urine output is below 0.5 mL/kg/hr.

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ESPGHAN 2022
For qualified clinicians. This page and the PediAid app are a clinical aid only. Calculations and reference data must be verified against the patient's clinical context, the source guideline and your local protocols before any treatment decision is made.