Exchangeable Potassium and Renal Potassium Handling in Advanced Chronic Renal Failure in Man

Abstract

Previously reported results for exchangeable potassium in advanced renal failure have been conflicting. We have studied, therefore, 13 patients in advanced chronic renal failure with a mean urea clearance of 3 ml/min and a mean creatinine clearance of 4.1 ml/min, and without evidence of unusual extrarenal potassium losses. The results of exchangeable potassium in both males and females were not significantly different from normal (43.3 mEq/kg in males and 35.9 mEq/ kg in females). In the majority of patients overall potassium secretion was observed. Our results do not support arbitrary potassium supplementation in patients treated conservatively for renal failure in an effort to improve their glucose tolerance.

Clinical Disorders of Hyperkalemia

“…It is also unlikely that impaired extrarenal K uptake results from excess total body potassium, which secondarily leads to an inability to "accept" an acute K load. Although controversy exists over the best method to quantitate K stores (65), total body and exchangeable K measurements in uremic patients usually reveal normal values (66)(67)(68). It therefore seems unlikely that the defect in extrarenal K tolerance results from chronic K retention and increased cellular K stores.…”

Uric Acid Transport in Renal Failure A Review

“…They are, however, fully in-keeping with the known functional capacity and adaptability of the remaining nephrons in the chronically diseased kidney. This capacity has been illustrated with regard to a number of substances, notably sodium, potassium, chloride, phosphate, and ammonia [1,3,5] and forms the basis of the 'intact nephron hypothesis' [6], The example of uric acid is particularly interesting in view of the bidirec tional nature of its transport mechanism.…”