TRANSFERS OF POTASSIUM IN RENAL INSUFFICIENCY 1

Abstract

Changes in the conpn. of serum potassium were studied in 26 patients with severe renal insufficiency. The serum K level was abnormally high in more than half of the 26 patients. The greatest elevations were associated with oliguria; but oliguria was not always followed by an elevation in concn. of the ion. In 10 of the patients the intake and excretion of K were measured and the distribution of the ion between the cells and extracellular fluid was calculated. The principal limiting factor in the excretion of K was reduction in the glomerular filtration rate. The serum K was depressed in 4 of the cases; in the one in which it was studied the rate of renal excretion was not abnormally increased. K was taken up by the cells in only 2 of the 9 cases with hyperkaliemia; this process was not clearly accelerated by the admn. of carbohydrate and insulin. Electrocardiographic evidence of intoxication occurred before death in the 4 patients with serum K greater than 7.4 m.eq. per liter.