Total Body Potassium in Long-Term Frusemide Therapy: Is Potassium Supplementation Necessary?

Dargie, H. J.; Boddy, K.; Kennedy, A. C.; King, Priscilla C.; Read, P. R.; Ward, David M.

doi:10.1136/bmj.4.5940.316

Cited by 53 publications

(16 citation statements)

References 15 publications

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“…In some instances a signifi cant body potassium depletion has been docu mented [2,[6][7][8][9], while in others body potassium was normal or only trivially reduced [3][4][5]10,11]. It is interesting and probably significant that the method of estimation of body potas sium content correlated closely to the observed findings.…”

Section: Discussionsupporting

confidence: 60%

“…It is interesting and probably significant that the method of estimation of body potas sium content correlated closely to the observed findings. With one exception [5], all the studies [2,[6][7][8][9] which utilized whole body radioisotope dilution technic with 42K (total exchangeable potassium) showed a significant body potas sium depletion, while those studies which uti lized whole body radioisotope counter and measured total body potassium revealed no significant depletion [3,4,10,11], The results of the present study adhere to that trend; our data were obtained by using the whole body counter and they showed no significant deple tion of potassium in the group as a whole. The disparity between the two sets of results ob tained in studies of similar populations seems then to be technical rather than one based on pathophysiology.…”

Section: Discussionmentioning

confidence: 99%

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The Renin-Aldosterone System and Thiazide-Induced Depletion of Total Body Potassium in Essential Hypertension

Carroll

1978

Nephron

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15 patients who had benign, uncomplicated essential hypertension, were treated with chlorthiazide (500 mg twice a day) with or without propranolol (10–20 mg 4 times a day), and the effect of the treatment on plasma renin activity (PRA), urinary aldosterone excretion, total body potassium (TBK) and plasma sodium and potassium was evaluated. TBK depletion was significant mathematically (more than 5% of TBK lost) in 7 patients, but not significant physiologically (less than 15% of TBK lost) in any except in one, who may have had other reason for TBK depletion. Although propranolol prevented the increase in PRA and aldosterone excretion, it did not prevent the modest TBK depletion. Dietary potassium intake may have some importance in the maintenance of normal body potassium during chronic treatment with thiazides for hypertension.

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Section: Discussionsupporting

confidence: 60%

Section: Discussionmentioning

confidence: 99%

The Renin-Aldosterone System and Thiazide-Induced Depletion of Total Body Potassium in Essential Hypertension

Carroll

1978

Nephron

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“…The purpose of this study was to determine and compare the prevalences of hypokalemia in geriatric patients taking diuretics alone or in combination with potassium supplements. Diuretics and aging have both been associated with potassium loss 11,12 ; however, it has also been found that potassium supplements are not consistently effective 13 . In our study the overall prevalence of hypokalemia in 161 geriatric patients residing in seven long‐term care facilities was 13.7 percent.…”

Section: Discussionmentioning

confidence: 53%

Female Preponderance in Diuretic‐associated Hypokalemia

Clark¹,

Wheatley²,

Rawlings³

et al. 1982

J American Geriatrics Society

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A retrospective review of the medical records of 161 geriatric nursing-home patients receiving diuretics alone or in combination with potassium supplements or potassium sparing-diuretics revealed a 13.7 per cent overall prevalence of hypokalemia. The prevalence of hypokalemia in patients receiving diuretics alone, diuretics with potassium supplements, and potassium-sparing diuretics with kaliuretic diuretics were similar. However, there was a significantly higher prevalence of hypokalemia in women (16.4 per cent) compared with men (3.0 per cent), P less than 0.05. In patients taking non-chloride salts of potassium, there was a significantly higher prevalence of hypokalemia than in those taking the chloride salt (3.6 per cent vs. 8 per cent, P less than 0.025). Seven per cent of patients taking diuretics with potassium supplements and 11.5 per cent of patients taking potassium-sparing diuretics had hyperkalemia. Thus, although many elderly women taking diuretics may have hypokalemia routine potassium supplementation for all non-digitalized geriatric patients receiving diuretics does not seem to be indicated.

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“…Dargie et al (1974) showed that patients with essential hypertension and normal renal function, who had been on 40 mg frusemide daily with or without potassium supplementation, showed no evidence of depletion of total body potassium.…”

Section: Discussionmentioning

confidence: 99%