Potassium metabolism in patients with rheumatoid arthritis. Effects of treatment with depot tetracosactrin, spironolactone, and oral supplements of potassium chloride.

Abstract

. Potassium metabolism in patients with rheumatoid arthritis. Effects of treatment with depot tetracosactrin, spironolactone, and oral supplements of potassium chloride. (1) Plasma and urine electrolytes and whole body potassium have been measured before and after a 2-week administration of depot tetracosactrin 0 5 mg on alternate days to eight patients with rheumatoid arthritis (RA). The effects of adding supplements of potassium chloride (48 mmol/d) and spironolactone 200 mg daily have been investigated. (2) Acute changes in red blood cell water and potassium content, plasma electrolyte concentration, and plasma 1 1-hydroxycorticosteroid levels were measured for 48 hours after a single intramuscular injection of 0 5 mg depot tetracosactrin in six patients with RA. (3) The measured total body potassium was significantly less than that predicted from the height, weight, and age formula in patients with RA. (4) Treatment with depot tetracosactrin resulted in an acute fall in plasma and red cell potassium independent of external potassium loss. (5) Two weeks of treatment with depot tetracosactrin resulted in hypokalaemia and a rise in plasma sodium and bicarbonate. There were no associated electrocardiogram changes or a rise in blood pressure. (6) Neither oral potassium supplements nor spironolactone altered total body potassium. (7) The significance of the findings and the physiological mechanisms underlying them are discussed.The relationship between plasma potassium and naturally occurring corticotrophin absorbed onto a corticosteroid as well as corticotrophin therapy has zinc phosphate complex (depot Synacthen-CIBA been studied by many workers (Goodman and 42, 915 Ma) showed that significant hypokalaemia Gillman, 1970;Havard, 1970; Kyle, Canary, Werdin, occuffed with 0 5 mg on alternate days or with higher and Clive, 1966;Ernest, 1967). Similarly, primary doses despite oral potassium supplements of 48 hyperaldosteronism has been investigated and mmol/d (Nuki, Jasani, Downie, Whaley, Dick, characteristically shows low total exchangeable Williamson, Paterson, Boyle, and Buchanan, potassium values (Conn, Cohen, Rovner, and Nesbit, 1970). 1965) and reduced muscle biopsy potassium contentWe report the results of measurements oftotal body (Conn and Lonis, 1956; Milne, Muehreke, and Aird, potassium, red blood cell potassium, and plasma 1957). electrolytes in patients with RA before and after Recently clinicopharmacological studies in patients treatment with this preparation, and data on total with rheumatoid arthritis (RA) treated with depot body potassium and plasma electrolytes after the tetracosactrin, a synthetic polypeptide containing addition of spironolactone or potassium supplethe N-terminal 24 of the 39 amino acids found in ments.

The relationship between uric acid and potassium in normal subjects.

“…A significant correlation was obtained between the total serum potassium and total body potassium and also between the total erythrocyte potassium and total body potassium. These latter findings confirm those of Boddy et al (1976) and in view of the anomalies noted in a study of potassium in patients with rheumatoid arthritis (Nuki et al, 1975) this method would seem to provide a simple basis for assessing further the status of potassium in this and possibly other disease situations.…”

A therapeutic role for potassium (K) to reduce pain and complications related to the cardiovascular system and bone in rheumatoid arthritis (RA): A clinical research perspective

“…T cells isolated from the synovial fluid of patients with RA were characterized as mainly Kv1.3 high CCR7 [21]. Experimental evidence supports the inhibitory effects of serum K on free radical formation and-oxidant damage [74]. However, the relationship between dietary K and K ion channels has not been investigated.…”

An Adjunct Role Of Potassium Rich Vegetarian Diet And A Novel Potassium Food Supplement To Improve Pain In Chronic Rheumatoid Arthritis On Supervised Standard Care: A Randomized Controlled Study

“…Weber (1974) advocated a strong link between potassium and RA (15,32). NHANES population surveys in USA reported a relatively low serum potassium in RA patients and an inadequate intake of potassium (16,33). A study from UK reported a low body potassium status (17).…”

“…Potassium is an essential micronutrient in health and disease ( 12,13). There are few published reports to suggest a clinical and a therapeutic role for potassium in RA but the evidence so far seems meager (14,15,16,17,18). The current study was planned against this background.…”

“…A relatively low serum potassium in RA was reported in population surveys (NHANES, USA) (11). Low potassium body status was reported using radioisotope labelling[12]. A daily administration of high dose of potassium chloride (mixed in grape juice) for 28 days showed significant improvement in 38 patients of RA in a randomized control study [13].…”