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Since the demonstration by Schrader, Prickett, and Salmon (1) of structural alterations in the tubules of the kidney of rats fed a diet deficient in K a series of investigations (2-12) has described renal lesions associated with K depletion both in experimental animals and in clinical states in which electrolyte balance has been disturbed by such incidents as prolonged diarrhea or vomiting.All the investigators agree that changes occur in the tubular epithelium of the nephron; there is no unanimity of opinion, however, on their nature or location. Fatty, vacuolar, and hydropic degeneration and even a general tubular necrosis, which in its severity is compared to the "necrotizing nephrosis" of heavy metal poisoning, have been noted along with the progressive changes of epithelial hyperplasia and cystic dilatation of tubules.Regarding the location of the lesions there is also disagreement: they are described by different investigators as in the proximal convolutions, the ascending limbs of the loops of Henle, the distal convolutions and the collecting tubules, either limited to certain of these segments or in various combinations.The more recent studies have emphasized the predominance of alterations in the collecting tubules. Spargo (10) describes increase in the size of the lumen of the "distal" and collecting tubules, along with an accumulation of hyaline or "colloid" droplets in the cells of the latter. There was an increase in both size and number of the cells in the tubular wall and mitotic figures were frequent. The droplets were PAS (periodic acid-Schiff reaction) positive and especially prominent near the papillae. Milne, Muehrcke, and Heard (11) report a similar finding of droplets, stressing not only their frequency in the ducts near the papilla but their occurrence in the epithelial