Table 3.

Teaching points

•Hypokalemic nephropathy is a progressive renal disease that is associated with chronic hypokalemia and may lead to end-stage kidney disease without prompt treatment.

•Clinical features include low urine specific gravity, polyuria, tubular proteinuria, and inactive urinary sediment.

•Biopsy findings include intracytoplasmic vacuoles in renal tubular cells, chronic inflammation, and interstitial fibrosis. The vacuoles in hypokalemic nephropathy are larger, irregular, and coarse and do not stain for fat or glycogen.

•Pathogenesis is mediated via an imbalance in vasoactive mediators, leading to vasoconstriction and medullary ischemia.

•Future prospective studies are needed to identify the effect of timely treatment of low potassium on reversal of renal damage.