Coffee-induced Hypokalaemia

Taking an excess amount of caffeine (e.g. overdrinking caffeinated beverages) sometimes causes hypokalaemia. Although the detailed mechanism has not been clarified yet, an increased loss of potassium via the urine stream caused by the diuretic action of caffeine is proposed as one of the possibilities. We report the case of a 50-year-old female outpatient who rapidly developed severe generalized muscle weakness and fatigue. Her symptoms were considered to be principally due to hypokalaemia. Since her blood urea nitrogen concentration decreased greatly, it was suggested that she had massive polyuria due to overhydration (i.e. dilution of her body fluids). Initially, we considered that a urinary tract infection might have caused her illness. However, we found that she was a heavy coffee drinker and had constantly experienced massive diuresis. After a course of oral antibiotics, potassium replacement and stopping coffee (caffeine) ingestion, her symptoms resolved quickly. In conclusion, it was considered that overdrinking coffee (caffeine) induced her hypokalaemia. Probably, loss of potassium via the urine stream with secondary aldosteronism was the main cause of the hypokalaemia.