Transfers of Cell Sodium and Potassium in Experimental and Clinical Conditions 1

Elkinton, J. R.; Winkler, Alexander W.; Danowski, T. S.

doi:10.1172/jci101926

Cited by 58 publications

(26 citation statements)

References 23 publications

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“…The data confirm previous studies in this laboratory and elsewhere (14) in showing that large 109 amounts of potassium may enter or leave the intracellular fluid with relatively small increments or decrements of the extracellular fraction of the ion. Some changes in concentration of extracellular potassium may take place.…”

Section: Discussionsupporting

confidence: 90%

“…The other chemical methods which were used, and the methods of calculation of the derived data, have been previously reported (14,16). In the present study the concentration of potassium in extracellular fluid was assumed to be the same as that in serum because of the uncertainty concerning the proportion of the latter which is non-diffusible.…”

Section: Methodsmentioning

confidence: 99%

“…In some of these conditions deficit of cellular potassium has been indicated by negative balances of potassium when the intake of potassium was low and retention of potassium when the ion was administered (10)(11)(12)(13). However, significant alterations in the cellular content of potassium may occur without much change in the amount and concentration of potassium in the extracellular fluid and serum (10,14). Levels of serum potassium therefore, may, but do not necessarily, reflect the state of depletion or repletion of cellular potassium.…”

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confidence: 99%

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Potassium Deficiency and the Role of the Kidney in Its Production 12

Tarail¹,

Elkinton²

1949

J. Clin. Invest.

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Section: Discussionsupporting

confidence: 90%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Potassium Deficiency and the Role of the Kidney in Its Production 12

Tarail¹,

Elkinton²

1949

J. Clin. Invest.

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“…Alterations in extracellular fluid volume were calculated from changes in the chloride space, based on the external balance of this anion and corrected for changes in the serum concentrations of chloride as described by Elkinton and co-workers, and by Darrow (17)(18)(19). In view of the dehydration known to develop in the course of diabetic acidosis and coma, the initial extracellular volume was assumed for purposes of this calculation to be 15 per cent of the body weight rather than the usual value of 18.7 to 23 per cent found in non-dehydrated human subjects (20).…”

Section: Methods Of Calculationmentioning

confidence: 99%

Studies in Diabetic Acidosis and Coma, With Particular Emphasis on the Retention of Administered Potassium

Danowski¹,

Peters²,

Rathbun³

et al. 1949

J. Clin. Invest.

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109

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Abnormally low concentrations of potassium, at times associated with muscular paralysis, have been observed in the serum of diabetic patients while under treatment for acidosis or coma (1)(2)(3)(4). Available data indicate that deficits of cell potassium are also present in at least some of these subjects (5). In an attempt to characterize and quantitate the magnitude of these deficits, exchanges of water, electrolytes, carbohydrate, and protein have been investigated in diabetic acidosis and coma prior to, during, and following the administration of potassium salts. EXPERIMENTAL PROCEDURE AND METHODSEight cases in all have been studied. Of these, two were adults and the remaining six juvenile diabetics 16 years of age or younger. On admission all had Kussmaul breathing, a marked reduction of the serum bicarbonate content, hyperglycemia, glycosuria, and ketonuria.Studies during treatment and recovery were divided into three periods. The first or pre-KCl period extended from admission to the point where the patients had improved sufficiently to be maintained on an oral intake. During this time insulin, 0.9 per cent saline, and, once the blood sugar began to drop, glucose solutions were administered in amounts summarized in Table I. Under this treatment ketosis diminished, overbreathing ceased, hyperglycemia decreased, and mental clarity returned. This interval lasted 12 to 25 hours in the individual subjects. During the second or KC1 period, 22 to 37 hours in length, the patients received insulin, 10.0 to 30.0 grams of KCI per os or intravenously, whole milk containing added carbohydrate, and water as desired. The third or post-KCl period began after the final dose of KC1 and lasted up to 34 hours. During this time the patients received insulin as needed, together with measured amounts of water and milk.In all subjects concentrations of the whole blood nonprotein nitrogen, blood sugar (6-8), and the levels of serum chloride, bicarbonate, sodium, potassium and water were measured at the beginning and end of each period (6,(9)(10)(11)(12). Average values for the electrolyte, carbohydrate, and protein content of fresh milk have been used in calculating the intake (13, 14). Urine excreted during each period was analyzed for nitrogen, sodium, potassium, chloride, and glucose (6, 10, 11, 15, 16). Body weight was determined when possible at the start and end of each period. METHOD OF CALCULATIONAlterations in extracellular fluid volume were calculated from changes in the chloride space, based on the external balance of this anion and corrected for changes in the serum concentrations of chloride as described by Elkinton and co-workers, and by . In view of the dehydration known to develop in the course of diabetic acidosis and coma, the initial extracellular volume was assumed for purposes of this calculation to be 15 per cent of the body weight rather than the usual value of 18.7 to 23 per cent found in non-dehydrated human subjects (20). In two instances a pre-treatment weight could not be obtained. A reasonable assumpt...

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“…The evidence in these experiments indicates that during the development of paralysis the osmotic activity of cell fluid is increased and conversely during recovery, is decreased. Besides, analysis of the relation of exchanges of sodium and potassium across the cell membrane to changes in osmotic activity of base within the cell, shows that there is little quantitative relationship between the two (29).…”

Section: Discussionmentioning

confidence: 99%