Abstract
The concentration of potassium in our cells is some 37 times higher than in the extracellular compartment. Maintenance of this transcellular concentration gradient is central for normal cell function in general and for nerve conduction and muscle contraction in particular. Not surprisingly, multiple homeostatic mechanisms regulate the internal distribution of K+, as well as maintaining body K+ stores stable. Disorders of K+ metabolism occur when one or more of these systems is disrupted. Such disorders are often asymptomatic or only associated with mild and nonspecific symptoms. As a result, they are usually first detected, sometimes incidentally, by uncovering an abnormality in serum potassium concentration ([K+]). Although often asymptomatic, disorders of K+ metabolism can also produce life-threatening cardiac arrhythmias or paralyses with little or no warning. In such instances, the ability to recognize the problem and intervene in a timely fashion can be lifesaving. Management of disorders of K+ metabolism is based firmly on an understanding of normal K+ homeostasis. As a necessary introduction to these disorders, a brief review of normal K+ balance is presented below.
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References
Holbrook JT, Patterson KY, Bodner JE, Douglas LW, Veillon C, Kelsay JL, Mertz W, Smith JC: Sodium and potassium intake and balance in adults consuming self-selected diets. Am J Clin Nutr 40: 786–793, 1984.
Hiatt N, Davidson MB, Bonorris G: The effect of potassium chloride infusion on insulin secretion in vivo. Horm Metab Res 4: 64–68, 1972.
Dluhy RG, Axelrod L, Williams GH: Serum immunoreactive insulin and growth hormone response to potassium infusion in normal man. J Appl Physiol 33: 22–26, 1972.
Santeusanio F, Faloona GR, Knochel JP, Unger RH: Evidence for a role of endogenous insulin and glucagon in the regulation of potassium homeostasis. J Lab Clin Med 81: 809817, 1973.
Martinez R, Rietberg B, Skyler J, Oster JR, Perez GO: Effect of hyperkalemia on insulin secretion. Experientia 47: 270272, 1991.
Clausen T, Everts ME: Regulation of the Na, K-pump in skeletal muscle. Kidney Int 35: 1–13, 1989.
Zierler K, Rogus EM: Rapid hyperpolarization of rat skeletal muscle induced by insulin. Biochim Biophys Acta 640: 687692, 1981.
Clausen T, Flatman JA: Effects of insulin and epinephrine on Na’-K’ and glucose transport in soleus muscle. Am J Physiol 252: E492 - E499, 1987.
Minaker KL, Rowe JW: Potassium homeostasis during hyperinsulinemia: Effect of insulin level, [3-blockade, and age. Am J Physiol 242: E373 - E377, 1982.
Zierler KL: Effect of insulin on potassium efflux from rat muscle in the presence and absence of glucose. Am J Physiol 198: 1066–1070, 1960.
DeFronzo RA, Sherwin RS, Dillingham M, Hendler R, Tamborlane WV, Felig P: Influence of basal insulin and glucagon secretion on potassium and sodium metabolism. J Clin Invest 61: 472–479, 1978.
Rowe JW, Tobin JD, Rosa RM, Andres R: Effect of experimental potassium deficiency on glucose and insulin metabolism. Metabolism 29: 498–502, 1980.
Landsberg L, Young JB: Fasting, feeding and regulation of the sympathetic nervous system. N Engl J Med 298: 1295 1301, 1978.
Rosa RM, Silva P, Young JB, Landsberg L, Brown RS, Rowe JW, Epstein FH: Adrenergic modulation of extrarenal potassium homeostasis. N Engl J Med 302: 431–434, 1980.
DeFronzo RA, Bia M, Birkhead G: Epinephrine and potassium disposal. Kidney Int 20: 83–91, 1981.
Brown MJ, Brown DC, Murphy MB: Hypokalemia from betaz receptor stimulation by circulating epinephrine. N Engl J Med 309: 1414–1419, 1983.
Pedersen EB, Kornerup HJ: Relationship between plasma aldosterone concentration and plasma potassium in patients with essential hypertension during alprenolol treatment. Acta Med Scand 200: 263–267, 1976.
Drayer JIM, Weber MA, Longworth DL, Laragh JH: The possible importance of aldosterone as well as renin in the long-term antihypertensive action of propranolol. Am J Med 64: 187–192, 1978.
McKenna TJ, Island DP, Nicholson WE, Liddle GW: The effects of potassium on early and late steps in aldosterone biosynthesis in cells of the zona glomerulosa. Endocrinology 103: 1411–1416, 1978.
Gann DS, Delea CS, Gill JR Jr, Thomas JP, Bartter FC: Control of aldosterone secretion by change of body potassium in normal man. Am J Physiol 207: 104–108, 1964.
Kassirer JP, Appleton FM, Chazan JA, Schwartz WB: Aldosterone in metabolic alkalosis. J Clin Invest 46: 1558–1571, 1967.
Pratt JH: Role of angiotensin II in potassium-mediated stimulation of aldosterone secretion in the dog. J Clin Invest 70: 667–672, 1982.
Stanton BA: Regulation of Na’ and K’ transport by mineralocorticoids. Semin Nephrol 7: 82–90, 1987.
Wang W, Schwab A, Giebisch G: Regulation of small conductance K. channel in apical membrane of rat cortical collecting tubule. Am J Physiol 250: F494 - F502, 1990.
Himathongkam T, Dluhy RG, Williams GH: Potassiumaldosterone-renin interrelationships. J Clin Endocrinol Metab 41: 153–159, 1975.
Keith NM, Osterberg AE, Burchell HB: Some effects of potassium salts in man. Ann Intern Med 16: 879–892, 1942.
Clive DM, Gurwitz JH, Rossetti RG: Potassium homeostasis with indomethacin therapy in normal subjects. Am J Kidney Dis 19: 16–21, 1992.
DeFronzo RA, Taufield PA, Black H, McPhedran P, Cooke CR: Impaired renal tubular potassium secretion in sickle cell diseasè. Ann Intern Med 90: 310–316, 1979.
Brown RS: Extrarenal potassium homeostasis. Kidney Int 30: 116–127, 1986.
Arriza JL, Weinberger C, Cerelli G, Glaser TM, Handelin BL, Housman DE, Evans RM: Cloning of human mineralocorticoid receptor complementary DNA: structural and func- tional kinship with the glucocorticoid receptor. Science 237: 268–275, 1987.
Armanini D, Strasser T, Weber PC: Characterization of aldosterone binding sites in circulating human mononuclear leukocytes. Am J Physiol 248: E388 - E390, 1985.
Meyer WJ, Nichols NR: Mineralocorticoid binding in cultured smooth muscle cells and fibroblasts from rat aorta. J Steroid Biochem 14: 1157–1168, 1981.
Ikeda U, Hyman R, Smith TW, Medford RM: Aldosteronemediated regulation of Na’, K’-ATPase gene expression in adult and neonatal rat cardiocytes. J Biol Chem 266: 120581 2066, 1991.
Clark BA, Brown RS, Epstein FH: Effect of atrial natriuretic peptide on potassium-stimulated aldosterone secretion: potential relevance to hypoaldosteronism in man. J Clin Endocrinol Metab 75: 399–403, 1992.
Nicolis GL, Kahn T, Sanchez A, Gabrilove L: Glucose-induced hyperkalemia in diabetic subjects. Arch Intern Med 141: 49–53, 1981.
Williams ME, Rosa RM, Silva P, Brown RS, Epstein FH: Impairment of extrarenal potassium disposal by a-adrenergic stimulation. N Engl J Med 311: 145–149, 1984.
Todd EP, Vick RL: Kalemotropic effect of epinephrine: analysis with adrenergic agents and antagonists. Am J Physiol 220: 1964–1969, 1971.
Williams ME, Gervino EV, Rosa RM, Landsberg L, Young JB, Silva P, Epstein FH: Catecholamine modulation of rapid potassium shifts during exercise. N Engl J Med 312: 823–827, 1985.
Kjeldsen K, NOrgaard A, Gatzsche CO, Thomassen A, Clausen T: Effect of thyroid function on number of Na-K pumps in human skeletal muscle. Lancet 2: 8–10, 1984.
Sugarman A, Kahn T: Parathyroid hormone impairs extrarenal potassium tolerance in the rat. Am J Physiol 254: F385 - F390, 1988.
Sugarman A, Kahn T: Calcium channel blockers enhance extrarenal potassium disposal in the rat. Am J Physiol 250: F695 - F701, 1986.
D¢rup I, Skajaa K, Clausen T, Kjeldsen K: Reduced concentrations of potassium, magnesium, and sodium-potassium pumps in human skeletal muscle during diuretic treatment. Br Med J 296: 455–458, 1988.
Kjeldsen K, Nargaard A, Clausen T: Effect of K-depletion on 3H-ouabain binding and Na-K-contents in mammalian skeletal muscle. Acta Physiol Scand 122: 103–117, 1984.
Adrogué HG, Madias NE: Changes in plasma potassium concentration during acute acid-base disturbances. Am J Med 71: 456–467, 1981.
Burnell JM, Villamil MF, Uyeno BT, Scribner BH: The effect in humans of extracellular pH change on the relationship between serum potassium concentration and intracellular potassium. J Clin Invest 35: 935–939, 1956.
Oster JR, Perez GO, Castro A, Vaamonde CA: Plasma potassium response to acute metabolic acidosis induced by mineral and nonmineral acids. Mineral Electrolyte Metab 4: 28–36, 1980.
Orringer CE, Eustace JC, Wunsch CD, Gardner LB: Natural history of lactic acidosis after grand-mal seizures: a model for the study of an anion-gap acidosis not associated with hyperkalemia. N Engl J Med 297: 796–799, 1977.
Fulop M: Serum potassium in lactic acidosis and ketoacidosis. N Engl J Med 300: 1087–1089, 1979.
Adrogué HG, Chap Z, Ishida T, Field JB: Role of the endocrine pancreas in the kalemic response to acute metabolic acidosis in conscious dogs. J Clin Invest 75: 798–808, 1985.
Gennari FJ, Cohen Ji: Role of the kidney in potassium homeostasis: lessons from acid-base disturbances. Kidney Int 8: 1–5, 1975.
Krapf R, Cadoff P, Wagdi P, Stäubli M, Hulter HN: The plasma potassium response to acute respiratory alkalosis. Kidney Int 47: 217–224, 1995.
Wright FS, Giebisch G: Renal potassium transport: Contributions of individual nephron segments and populations. Am J Physiol 235: F515 - F527, 1978.
Wright FS, Giebisch G: Regulation of potassium excretion. In: DW Seldin, G Giebisch, eds, The Kidney, 2nd ed. Raven Press, New York, pp 2209–2247, 1992.
Field MJ, Giebisch G: Hormonal control of renal potassium excretion. Kidney Int 27: 379–387, 1985.
Seldin DW, Welt LG, Cort JH: The role of sodium salts and adrenal steroids in the production of hypokalemic alkalosis. Yale J Biol Med 29: 229–247, 1956.
Good DW, Wright FS: Luminal influences on potassium secretion: Sodium concentration and fluid flow rate. Am J Physiol 236: F192 - F205, 1979.
Stokes JB: Potassium secretion by cortical collecting tubule: relation to sodium absorption, luminal sodium concentration, and transepithelial voltage. Am J Physiol 241: F395 - F402, 1981.
Relman AS, Schwartz WB: The effect of DOCA on electrolyte balance in normal man and its relation to sodium chloride intake. Yale J Biol Med 24: 540–558, 1952.
Schwartz WB, Jenson RL, Reiman AS: Acidification of the urine and increased ammonium excretion without change in acid-base equilibrium: sodium reabsorption as a stimulus to the acidifying process. J Clin Invest 34: 673–680, 1955.
Velazquez H, Wright FS, Good DW: Luminal influences on potassium secretion: chloride replacement with sulfate. Am J Physiol 242: F46 - F55, 1982.
Velazquez H, Ellison DH, Wright FS: Chloride-dependent potassium secretion in early and late renal distal tubules. Am J Physiol 253: F555 - F562, 1987.
Stanton BA, Giebisch G: Effects of pH on potassium transport by renal distal tubule. Am J Physiol242:F544–F551,1982.
Stanton BA, Giebisch GH: Potassium transport by the renal distal tubule: effects of potassium loading. Am J Physiol 243: F487 - F493, 1982.
Hayslett JP, Binder HJ: Mechanism of potassium adaptation. Am J Physiol 243: F103 - F112, 1982.
Doucet A, Marsy S: Characterization of K-ATPase activity in distal nephron: stimulation by potassium depletion. Am J Physiol 253: F418 - F423, 1987.
Wingo CS: Potassium transport by medullary collecting tubule of rabbit: effects of variation in K’ intake. Am J Physiol 253: F1136 - F1141, 1987.
Wingo CS: Active proton secretion and potassium absorption in the rabbit outer medullary collecting duct. Functional evidence for proton-potassium-activated adenosine triphosphatase. J Clin Invest 84: 361–365, 1989.
Hayes CP Jr, McLeod ME, Robinson RR: An extrarenal mechanism for the maintenance of potassium balance in severe chronic renal failure. Trans Assoc Am Physicians 80: 207–216, 1967.
Paice BJ, Paterson KR, Onyanga-Omara F, Donnelly T, Gray JMB, Lawson DH: Record linkage study of hypokalaemia in hospitalized patients. Postgrad Med J 62: 187–191, 1986.
Lawson DH, Henry DA, Lowe JM, Gray JMB, Morgan HG: Severe hypokalemia in hospitalized patients. Arch Intern Med 139: 978–980, 1979.
Adams PC, Woodhouse KW, Adela M, Parnham A: Exaggerated hypokalaemia in acute myeloid leukemia. Br Med 282: 1034–1035, 1981.
Naparstek Y, Gutman A: Spurious hypokalemia in myeloproliferative disorders. Am J Med Sci 288: 175–177, 1984.
Depner TA, Magee JA: Severe hypokalemia associated with pseudohypoxemia in acute nonlymphocytic leukemia. West J Med 149: 332–334, 1988.
Khuri RN, Agulian SK, Abdulnour-Nakhoul S, Nakhoul NL: Electrochemical potentials of potassium in skeletal muscle under different metabolic states. J Cell Physiol 153: 534–538, 1992.
Surawicz B: Relationship between electrocardiogram and electrolytes. Am Heart J 73: 814–834, 1967.
Fisch C: Relation of electrolyte disturbances to cardiac arrhythmias. Circulation 47: 408–419, 1973.
Nordrehaug JE: Malignant arrhythmias in relation to serum potassium values in patients with an acute myocardial infarction. Acta Med Scan (Suppl) 647: 101–107, 1981.
Hulting J: In-hospital ventricular fibrillation and its relation to serum potassium. Acta Med Scand (Suppl) 647: 109–116, 1981.
Schulman M, Narins RG: Hypokalemia and cardiovascular disease. Am J Cardiol 65: 4E - 9E, 1990.
Duke M: Thiazide-induced hypokalemia. Association with acute myocardial infaction and ventricular fibrillation. JAMA 239: 43–45, 1978.
Brunner HR, Baer L, Sealey JE, Ledingham JGG, Laragh JH: The influence of potassium administration and of potassium deprivation on plasma renin in normal and hypertensive subjects. J Clin Invest 49: 2128–2138, 1970.
Carliner NH, Schelling J-L, Russell RP, Okun R, Davis M: Thiazide-and phthalimidine-induced hyperglycemia in hypertensive patients. JAMA 191: 535–540, 1965.
Conn JW: Hypertension, the potassium ion and impaired carbohydrate tolerance. N Engl J Med 273: 1135–1143, 1965.
Schwartz WB, Relman AS: Effects of electrolyte disorders on renal structure and function. N Engl J Med 276: 383–389, 1967.
Manitius A, Levitin H, Beck D, Epstein FH: On the mechanism of impairment of renal concentrating ability in potassium deficiency. J Clin Invest 39: 684–692, 1960.
Krishna GG, Miller E, Kapoor S: Increased blood pressure during potassium depletion in normotensive men. N Engl J Med 320: 1177–1182, 1989.
Krishna GG: Effect of potassium intake on blood pressure. J Am Soc Nephrol 1: 43–52, 1990.
Knochel JP: Neuromuscular manifestations of electrolyte disorders. Am J Med 72: 521–535, 1982.
Campion DS, Arias M, Carter NW: Rhabdomyolysis and myoglobinuria. Association with hypokalemia of renal tubular acidosis. JAMA 220: 967–969, 1972.
Christiensen KS: Hypokalemic periodic paralysis secondary to renal tubular acidosis. Eur Neurol 24: 303–305, 1985.
Alvarez J, Low RB: Acute respiratory arrest due to hypokalemia. Ann Emerg Med 17: 288–289, 1988.
Morgan DB, Young RM: Acute transient hypokalaemia: new interpretation of a common event. Lancet 2: 751–752, 1982.
Wadstein J, Skude G: Does hypokalaemia precede delirium tremens? Lancet 2: 549–550, 1978.
Laso FJ, Gonzalez-Buitrago JM, Martin-Ruiz C, Vicens E, Moyano JC: Inter-relationship between serum potassium and plasma catecholamines and 3’:5’ cyclic monophosphate in alcohol withdrawal. Drug Alcohol Depend 26: 183–188, 1990.
Bremner P, Burgess C, Beasley R, Woodman K, Marshall S, Crane J, Pearce N: Nebulized fenoteral causes greater cardiovascular and hypokalaemic effects than equivalent bronchodilator doses of salbutamol in asthmatics. Respir Med 86: 419–423, 1992.
Burgess CD, Flatt A, Siebers R, Crane J, Beasley R, Purdie G: A comparison of the extent and duration of hypokalaemia following three nebulized Betaz adrenoceptor agonists. EurJ Clin Pharmacol 36: 415–417, 1989.
McCleave DJ, Phillips PJ, Vedig AE: Compartmental shift of potassium—a result of sympathomimetic overdose. Aust NZ J Med 8: 180–183, 1978.
Kearney TE, Manoguerra AS, Curtis GP, Ziegler MG: Theophylline toxicity and the beta-adrenergic system. Ann Intern Med 102: 766–769, 1985.
Atuk NO, Blaydes MC, Westervelt FB Jr, Wood JE Jr: Effect of aminophylline on urinary excretion of epinephrine and norepinephrine in man. Circulation 35: 745 753, 1967.
Zantvoort FA, Derkx FHM, Boomsma F, Roos PJ, Schalekamp MADH: Theophylline and serum electrolytes. Ann Intern Med 104: 134, 1986.
Shannon M, Lovejoy FH Jr: Hypokalemia after theophylline intoxication: the effects of acute vs chronic poisoning. Arch Intern Med 149: 2725–2729, 1989.
Passmore AP, Kondowe GB, Johnston GD: Caffeine and hypokalemia. Ann Intern Med 105: 468, 1986.
Minella RA, Schulman DS: Fatal verapamil toxicity and hypokalemia. Am Heart J 121: 1810–1812, 1991.
Lofaso F, Baud FJ, Halna du Fretay X, Bismuth C, Staikowsky F, Sidhom N: Hypokaliémie an cours d’intoxications massives par la chloroquine. Presse Med 16: 22–24, 1987.
Liu GZ, Lyle KC, Cao J: Experiences with gossypol as a male pill. Am J Obstet Gynecol 157: 1079–1081, 1987.
Tam S-C: Acute hypokalemic effect of gossypol. Can J Physiol Pharmacol 64: 881–884, 1986.
Ober KP: Thyrotoxic periodic paralysis in the United States. Medicine 71: 109–120, 1992.
Chronos N, Mendel P, Ozin RL: Thyrotoxicosis presenting as life threatening hypokalaemic paralysis: investigation of the Na/K pump in isolated leukocytes. Br J Clin Pract 47: 106108, 1993.
Oh VMS, Taylor EA, Yeo S-H, Lee K-O: Cation transport across lymphocyte plasma membranes in euthyroid and thyrotoxic men with and without hypokalaemic periodic paralysis. Clin Sci 78: 199–206, 1990.
Chan A, Shinde R, Chow CC, Cockram CS, Swaminathan R: In vivo and in vitro sodium pump activity in subjects with thyrotoxic periodic paralysis. Br Med J 303: 1096–1099, 1991.
Kjeldsen K, Nt rgaard A, G¢tzsche CO, Thomassen A, Clausen T: Effect of thyroid function on number of Na–K pumps in human skeletal muscle. Lancet 2: 8–10, 1984.
Conway MJ, Seibel JA, Eaton RP: Thyrotoxicosis and peri- 133. odic paralysis: improvement with beta blockade. Ann Intern Med 81: 332–336, 1974. 134.
Yeung RTT, Tse TF: Thyrotoxic periodic paralysis. Am J Med 57: 584–590, 1974.
Johnsen T: Familial periodic paralysis with hypokalaemia. Dan Med Bull 28: 1–27, 1981. 135.
Kantola IM, Tarssanen LT: Familial hypokalaemic periodic paralysis in Finland. J Neurol Neurosurg Psychiatr 55: 322324, 1992. 136.
Corbett VA, Nuttall FQ: Familial hypokalemic periodic paralysis in blacks. Ann Intern Med 83: 63–65, 1975.
Minaker KL, Meneilly GS, Flier JS, Rowe JW: Insulin- 137. mediated hypokalemia and paralysis in familial hypokalemic periodic paralysis. Am J Med 84: 1001–1006, 1988.
Stedwell RE, Allen KM, Binder LS. Hypokalemic paralyses: a review of the etiologies, pathophysiology, presentation, and 138. therapy. Am J Emerg Med 10: 143–148, 1992.
Baruma OJS, Bots GTAM, Went LN: Familial hypokalemic periodic paralysis. 50 year followup of a large family. Arch 139. Neurol 42: 28–31, 1985.
Links TP, Zwartz MJ, Wilmink JT, Molenaar WM, 140. Oosterhius HJGH: Permanent muscle weakness in familial hypokalaemic periodic paralysis. Clinical, radiological and 141. pathological aspects. Brain 113: 1873–1889, 1990.
Streeten DHP, Speller PJ, Fellerman H: Use of corticotropin-induced potassium changes in the diagnosis of both hypo-and hyperkalemic periodic paralysis. Eur Neurol 142. 33: 103–108, 1993.
Vroom FQ, Jarrell MA, Maren TH: Acetozolamide treatment of hypokalemic periodic paralysis. Arch Neurol 32:385— 143. 392, 1975.
Jarrell MA, Greer M, Maren TH: The effect of acidosis in 144. hypokalemic periodic paralysis. Arch Neurol 33: 791–793, 1976. 145.
Johnson CH, Van Tassell VJ: Acute barium poisoning with respiratory failure and rhabdomyolysis. Ann Emerg Med 20: 1138–1142, 1991. 146.
Shankle R, Keane JR: Acute paralysis from inhaled barium carbonate. Arch Neurol 45: 579–580, 1988. 147.
Hesp R, Chanarin I, Tait CE: Potassium changes in megaloblastic anaemia. Clin Sci Mol Med 49: 77–79, 1975.
Rao TLK, Mathru M, Salem MR, Adel AE: Serum potassium levels following transfusions of frozen erythrocytes. An- 148. esthesiology 52: 170–172, 1980.
Weinsier RL, Bacon J, Butterworth CE Jr: Central venous alimentation: a prospective study of the frequency of meta- 149. bolic abnormalities among medical and surgical patients. Journal of Parenteral and Enteral Nutrition 6: 421–425, 1982.
Hernandez RE, Schambelan M, Cogan MG, Colman J, 150. Morris RC Jr, Sebastian A: Dietary NaC1 determines the severity of potassium depletion-induced metabolic alkalosis. 151. Kidney Int 31: 1356–1367, 1987.
Squires RD, Huth EJ: Experimental potassium depletion in normal human subjects. I. Relation of ionic intakes to the 152. renal conservation of potassium. J Clin Invest 38: 1134–1148, 1959. 153.
Silva P, Spokes K: Sympathetic system in potassium homeostasis. Am J Physiol 241: F151 — F155, 1981.
Drenick EJ, Bland W, Singer FR, Lederer M: Body 154. potassium content in obese subjects and potassium depletion during prolonged fasting. Am J Clin Nutr 18: 278–285, 155. 1966.
Garrow JS: Total body-potassium in kwashiorkor and marasmus. Lancet 2: 455–458, 1965.
Bonne OB, Bloch M, Berry EM: Adaptation to severe chronic hypokalemia in anorexia nervosa: a plea for conservative mananagement. Int J Eating Disorders 13: 125–128, 1993.
Harris RT: Bulimarexia and related serious eating disorders with medical complications. Ann Intern Med 99: 800–807, 1983.
Knochel JP, Dotin LN, Hamburger RJ: Pathophysiology of intense physical conditioning in a hot climate. J Clin Invest 51: 242–255, 1972.
Hart GR, Anderson RI, Crumpler CP, Shulkin A, Reed G, Knochel JP: Epidemic classical heat stroke: clinical characteristics and course of 28 patients. Medicine 61: 189–197, 1982.
Foster ES, Hayslett JP, Binder HJ: Mechanism of active potassium absorption and secretion in the rat colon. Am J Physiol 246: G611 — G617, 1984.
Fordtran JS: Speculations on the pathogenesis of diarrhea. Fed Proc 26: 1405–1414, 1967.
Reid AC, Draper IT: Flaccid quadriparesis due to salmonella enteritis. Scot Med J 25: 129–130, 1980.
daSilva OA, Amaral CFS, daSilveira JCB, López M, Pittella JEH: Hyperkalemic respiratory muscle paralysis following strongyloides stercoralis hyperinfection. Am J Trop Med Hyg 30: 69–73, 1981.
Orman RA, Lewis JB Jr: Flaccid quadriparesis associated with yersinia enterocolitis-induced hypokalemia. Arch Intern Med 149: 1193–1194, 1989.
Lopez AP, Gorbach LS: Diarrhea in AIDS. Infect Dis Clin North Am 2: 705–718, 1988.
Guerra I, Kimmel PL: Hypokalemic adrenal crisis in a patient with AIDS. South Med J 84: 1265–1267, 1991.
Schwartz WB, Reiman AS: Metabolic and renal studies in chronic potassium depletion resulting from overuse of laxatives. J Clin Invest 32: 258–271, 1953.
Basser LS: Purgatives and periodic paralysis. Med J Aust 1: 47–48, 1979.
Meyers AM, Feldman C, Sonnekus MI, Ninin DT, Margolius LP, Whalley NA: Chronic laxative abusers with pseudo-idiopathic oedema and autonomous pseudo-Bartter’s syndrome. S Afr Med J 78: 631–636, 1990.
Simodynes E: Preoperative shock secondary to severe hypokalemia and hypocalcemia from recreational enemas. Anesth Analg 60: 762 763, 1981.
O’Dorisio TM, Mekhjian HS, Gaginella TS: Medical therapy of VlPomas. Endocrinol Metab Clin North Am 18: 545–556, 1989.
Schrock LG, Polk HC Jr: Rectal villous adenoma producing hypokalemia. Am Surgeon 40: 54–59, 1974.
Chisholm JC Jr: Zollinger—Ellison syndrome: intermittent diarrhea, relentless hypokalemia, and hypergastrinemia. J Nati Med Assoc 73: 1151–1154, 1981.
Verner JV, Morrison AB: Endocrine pancreatic islet disease with diarrhea. Arch Intern Med 133:492–500, 1974. Campbell JM, Hunt TK, Karam JH, Forsham PH: Jejunoileal bypass as a treatment of morbid obesity. Arch Intern Med 137: 602–610, 1977.
Cooke WT: Water and electrolyte upsets in the stratorrhea syndrome. J Mt Sinai Hosp 24:221–231, 1957. Holmberg C, Perheentupa J, Launiala K, Hallman N: Con- genital chloride diarrhoea. Arch Dis Child 52: 255–267, 1977.
Slavin RE, Dias MA, Saral R: Cytosine arabinoside induced gastrointestinal toxic alterations in sequential chemotherapeutic protocols: a clinical-pathologic study of 33 patients. Cancer 42: 1747–1759, 1978.
Murai K, Tsuruta K, Yamamura Y, Kuribayashi T, Kurihara T, Matsukura S: Hypokalemic myopathy associated with radiation enteropathy. Eur Neurol 25: 444–447, 1986.
Gonzalez JJ, Owens W, Ungaro PC, Werk EE Jr, Wentz PW: Clay ingestion: a rare cause of hypokalemia. Ann Intern Med 97: 65–66, 1982.
Gennari FJ: Hypokalemia in metabolic alkalosis: a new look at an old controversy. In: M Hatano, ed, Nephrology. Proceedings of the XJth International Congress of Nephrology. Springer Verlag, Tokyo, pp 262–269, 1991.
Rimmer JM, Gennari FJ: Metabolic alkalosis. J Intensive Care Med 2: 137–150, 1987.
Kassirer JP, Harrington JT: Diuretics and potassium metabolism: a reassessment of the need, effectiveness and safety of potassium therapy. Kidney Int 11: 505–515, 1977.
Nader PC, Thompson JR, Alpern RJ: Complications of diuretic use. Semin Nephrol 8: 365–387, 1988.
Morgan DB, Davidson C: Hypokalaemia and diuretics: an analysis of publications. Br Med J 280: 905–908, 1980.
Licht JH, Haley RI, Pugh B, Lewis SB: Diuretic regimens in essential hypertension. A comparion of hypokalemic effects, BP control and cost. Arch Intern Med 143: 1694–1699, 1983.
Katz FH, Eckert RC, Gebott MD: Hypokalemia caused by surreptitious self-administration of diuretics. Ann Intern Med 76: 85–90, 1972.
Jamison RL, Ross JC, Kempson RL, Sufit CR, Parker TE: Surreptitious diuretic ingestion and pseudo-Bartter’s syndrome. Am J Med 73: 142–147, 1982.
Kassirer JP, Schwartz WB: The response of normal man to selective depletion of hydrochloric acid. Am J Med 40: 10–18, 1966.
Kassirer JP, Berkman PM, Lawrenz DR, Schwartz WB: The critical role of chloride in the correction of hypokalemic alkalosis in man. Am J Med 38: 172–189, 1965.
Harrington JT, Kassirer JP: Metabolic alkalosis. In: JJ Cohen, JP Kassirer (with the collaboration of FJ Gennari, JT Harrington, NE Madias), Acid-Base. Little, Brown, Boston, pp 227–306, 1982.
Veldhuis JD, Bardin CW, Demers LM: Metabolic mimicry of Bartter’s syndrome by covert vomiting. Am J Med 66: 36 1363, 1979.
Gill JR Jr, Bartter FC: Evidence for a prostaglandin-independent defect in chloride reabsorption in the loop of Henle as a proximal cause of Bartter’s syndrome. Am J Med 65: 766–772, 1978.
Klastersky J, Vanderkelen B, Daneau D, Mathieu M: Carbenicillin and hypokalemia. Ann Intern Med 78: 774–775, 1973.
Brunner FP, Frick PG: Hypokalaemia, metabolic alkalosis, and hyponatraemia due to “massive” sodium penicillin therapy. Br Med J 4: 550–552, 1968.
Mohr JA, Clark RM, Waack TC, Whang R: Nafcillinassociated hypokalemia. JAMA 242: 544, 1979.
Gill MA, Dubé JE, Young WW: Hypokalemic, metabolic alkalosis induced by high-dose ampicillin sodium. Am J Hosp Pharm 34: 528–531, 1977.
Conn JW, Knopf RF, Nesbit RM: Clinical characteristics of primary aldosteronism from an analysis of 145 cases. Am J Surg 107: 159–172, 1964.
Weinberger MH, Grim CE, Hollifield JW, Kem DC, Ganguly A, Kramer NJ, Yune HY, Wellman H, Donohue JP: Primary aldosteronism. Ann Intern Med 90: 386–395, 1979.
Bravo EL, Tarazi RC, Dustan HP, Fouad FM, Textor SC. Giford RW, Vidt DG: The changing clinical spectrum of primary aldosteronism. Am J Med 74: 641–651, 1983.
Biglieri EG, Irony I, Kater CE: Adrenocortical forms of human hypertension. In: JH Laragh, BM Brenner, eds, Hypertension. Raven Press, New York, pp 1609–1624, 1990.
Kassirer JP, London AM, Goldman DM, Schwartz WB: On the pathogenesis of metabolic alkalosis in hyperaldosteronism. Am J Med 49: 306–315, 1973.
Rich GM, Ulick S, Cook S, Wang JZ, Lifton RP, Dluhy RG: Glucocorticoid-remediable aldosteronism in a large kindred: Clinical spectrum and diagnosis using a characteristic biochemical phenotype. Ann Intern Med 116: 813–820, 1992.
Lifton RP, Dluhy RG, Powers M, Rich GM, Cook S, Ulick S, Lalouel J: A chimaeric 11 ß-hydroxylase/aldosterone synthase gene causes glucocorticoid-remediable aldosteronism and human hypertension. Nature 355: 262–265, 1992.
Corvol P, Pinet F, Galen FX, Plouin PF, Chatellier G, Pagny JY, Bruneval P, Camilleri JP, Ménard J: Primary reninism In: JH Laragh, BM Brenner, eds, Hypertension. Raven Press, New York, pp 1573–1582, 1990.
Simon N, Franklin SS, Bleifer KH, Maxwell MH: Clinical characteristics of renovascular hypertension. DAMA 220: 1209–1218, 1972.
White RH, Schambelan M: Hypertension, hyperreninemia, and secondary hyperaldosteronism in systemic necrotizing vasculitis. Ann Intern Med 92: 199–201, 1980.
Ruby ST, Burch A, White WB: Unilateral renal artery stenosis seen initially as severe and symptomatic hypokalemia. Arch Surg 128: 346–348, 1993.
Edwards CRW, Walker BR, Benediktsson R, Seckl JR: Congenital and acquired syndromes of apparent mineralocorticoid excess. J Steroid Biochem Mol Biol 45: 1–5, 1993.
Biglieri EG, Kater CE: Mineralocorticoids in congenital adrenal hyperplasia. J Steroid Biochem Mol Biol 40: 493–499, 1991.
Prunty FTG, Brooks RV, Dupré J, Gimlette TMD, Hutchinson JSM, McSwiney RR, Mills IH: Adrenocortical hyperfunction and potassium metabolism in patients with “non-endocrine” tumors and Cushing’s syndrome. J Clin Endocrinol Metab 23: 737–746, 1963.
Mantero F, Boscaro M: Glucocorticoid-dependent hypertension. J Steroid Biochem Mol Biol 43: 409–413, 1992.
Stewart PM, Come JET, Shackleton CHL, Edwards CRW: Syndrome of apparent mineralocorticoid excess. J Clin Invest 82: 340–349, 1988.
Clore J, Schoolwerth A, Watlington CO: When is cortisol a mineralocorticoid? Kidney Int 42: 1297–1308, 1992.
Stewart PM, Wallace AM, Valentine R, Burt D, Shackleton CHL, Edwards CRW: Mineralocorticoid activity of liquorice: 11-beta-hydroxysteroid dehydrogenase deficiency comes of age. Lancet 2: 821–824, 1987.
Farese RV, Biglieri EG, Shackleton CHL, Irony I, Gomez-Fontes R: Licorice-induced hypermineralocorticoidism. N Engl J Med 325: 1223–1227, 1991.
Stewart PM, Wallace AM, Atherden SM, Shearing CH, Edwards CRW: Mineralocorticoid activity of carbenoxolone: contrasting effects of carbenoxolone and liquorice on 1113- hydroxysteroid dehydrogenase activity in man. Clin Sci 217. Atchley DW, Loeb RF, Richards DW, Benedict EM, 78:49–54, 1990. Driscoll ME: On diabetic acidosis: a detailed study of electro-
Nielsen I, Pedersen RS: Life-threatening hypokalaemia lyte balances following the withdrawal and reestablishment caused by liquorice ingestion. Lancet 1:1305, 1984. of insulin therapy. J Clin Invest 12: 297–326, 1933.
Young WF, Klee GG: Primary aldosteronism. Diagnostic 218. Brodsky WA, Rapoport S, West CD: The mechanism of evaluation. Endocrinol Metab Clin North Am 17:367–395, glycosuric diuresis in diabetic man. J Clin Invest 29:1021–1988. 1032, 1950.
Bravo EL: Primary aldosteronism. Urol Clin North Am 219. Adrogué HJ, Lederer ED, Suki WN, Eknoyan G: Determi- 16:481–486, 1989. nants of plasma potassium levels in diabetic ketoacidosis.
Biglieri EG: Spectrum of mineralocorticoid hypertension. Medicine 65:163–172, 1986. Hypertension 17:251–261, 1991. 220. Fulop M: Hyperkalemia in diabetic ketoacidosis. Am J Med
Bartter FC, Pronove P, Gill JR Jr, MacCardle RC: Sci 299:164–169, 1990. Hyperplasia of the juxtaglomerular complex with 221. Solomon R: The relationship between disorders of K’ and hyperaldosteronism and hypokalemic alkalosis. Am J Med Mg’ homeostasis. Semin Nephrol 7:253–262, 1987. 33:811–828, 1962. 222. Shils ME: Experimental human magnesium depletion. Medi-
Gill JR Jr: Bartter’s syndrome. Ann Rev Med 31:405–419, cine 48:61–85, 1969. 1980. 223. Shils ME: Experimental production of magnesium deficiency
Stein JH: The pathogenetic spectrum of Bartter’s syndrome. in man. Ann NY Acad Sci 162:847–855, 1969. Kidney Int 28:85–93, 1985. 224. Dunn MJ, Walser M: Magnesium depletion in normal man.
Fichman MP, Telfor N, Zia P, Speckart P, Golub M, Rude R: Metabolism 15:884–895, 1966. Role of prostaglandins in the pathogenesis of Bartter’s syn- 225. Evans RA, Carter JN, George CRP, Walls RS, Newland RC, drome. Am J Med 60:785–797, 1976. McDonnell GD, Lawrence JR: The congenital “magnesium-
Verbeckmoes R, van Damme B, Clement J, Amery A, losing kidney.“ Report of two patients. Q J Med 50:39–52, Michielsen P: Bartter’s syndrome with hyperplasia of 1981. renomedullary cells. Successful treatment with indo- 226. Whang R, Flink EB, Dyckner T, Wester PO, Aikawa JK, methacin. Kidney Int 9:302–307, 1976. Ryan MP: Magnesium depletion as a cause of refractory
Gill JR Jr, Frölich JC, Bowden RE, Taylor AA, Keiser HR, potassium repletion. Arch Intern Med 145:1686–1690, 1985. Seyberth HW, Oates JA, Bartter FC: Bartter’s syndrome. A 227. Rodriguez M, Solanki DL, Whang R: Refractory potassium disorder characterized by high urinary prostaglandins and a repletion due to cisplatin-induced magnesium depletion. dependence of hyperreninemia on prostaglandin synthesis. Arch Intern Med 149:2592–2594, 1989. Am J Med 61:43–51, 1976. 228. Holmes AM, Hesling CM, Wilson TM: Drug-induced sec-
Gitelman HJ: Hypokalemia, hypomagnesemia, and alkalosis: ondary hyperaldosteronism in patients with pulmonary tu- A rose is a rose—or is it? J Pediatr 120:79–80, 1992. berculosis. Q J Med 39: 299–315, 1970.
Gill JR Jr, Bell NH, Bartter FC: Impaired conservation of 229. Bar RS, Wilson HE, Mazzaferri EL: Hypomagnesemic sodium and potassium in renal tubular acidosis and its correc hypocalcemia secondary to renal magnesium wasting. A pos- tion by buffer anions. Clin Sci 33:577–592, 1967. sible consequence of high-dose gentamicin therapy. Ann In-
Gennari FJ, Cohen JJ: Renal tubular acidosis. Annu Rev Med tern Med 82:646–649, 1975. 29:521–541, 1978. 230. Gearhart MO, Sorg TB: Foscarnet-induced severe hypo-
Sebastian A, Hulter HN, Kurtz I, Maher T, Schambelan M: magnesemia and other electrolyte disorders. Ann Disorders of distal nephron function. Am J Med 72:289–307, Pharmacother 27:285–289, 1993. 1982. 231. Barton CH, Pahl M, Vaziri ND, Cesario T: Renal magnesium
Sebastian A, McSherry E, Morris RC Jr: Renal potassium wasting associated with amphotericin B therapy. Am J Med wasting in renal tubular acidosis (RTA). Its occurrence in 77:471–474, 1984. types 1 and 2 RTA despite sustained correction of systemic 232. Burgess JL, Birchall R: Nephrotoxicity of amphotericin B, acidosis. J Clin Invest 50:667–678, 1971. with emphasis on changes in tubular function. Am J Med
Wrong OM, Feest TG, Maclver AG: Immune-related 53:77–84, 1972. potassium-losing interstitial nephritis: a comparison with 233. Mir MA, Brabin B, Tang OT, Leyland MJ, Delamore IW:
distal renal tubular acidosis. Q J Med 86:513–534, Hypokalaemia in acute myeloid leukaemia. Ann Intern Med
:54–57, 1975.
Caruana RJ, Buckalew VM: The syndrome of distal (type I) 234. Fisher JR: Hypokalemia in leukemia. Ann Intern Med 86:363, renal tubular acidosis. Medicine 67: 84–99, 1988. 1977.
Lightwood R, Payne WW, Black JA: Infantile renal acidosis. 235. Lantz B, Carmark B, Reizenstein P: Electrolytes and whole
Pediatrics 12:628–644, 1953. body potassium in acute leukemia. Acta Med Scand 206:45-
Brenes LG, Brenes JN, Hernandez MM: Familial proximal 50, 1979.
renal tubular acidosis. Am J Med 63:244–252, 1977. 236. Perry MC, Bauer JH, Farhangi M: Hypokalemia in acute
Sebastian A, McSherry E, Morris RC Jr: On the mechanism myelogenous leukemia. South Med J 76:958–961, 1983. of potassium wasting in renal tubular acidosis associated with 237. Sterns RH, Cox M, Feig PU, Singer I: Internal potassium the Fanconi syndrome (type 2 RTA). J Clin Invest 50:231 balance and the control of the plasma potassium concentra- 243, 1971. tion. Medicine 60: 339–354, 1981.
Harrington JT, Cohen JJ. Metabolic acidosis. In: JJ Cohen, 238. Lawson DH: Adverse reactions to potassium chloride. Q J JP Kassirer (with collaboration of FJ Gennari, JT Med 171:433–440, 1974. Harrington, NE Madias), Acid–Base. Little, Brown, Boston, 239. Ponce SP, Jennings AE, Madias NE, Harrington JT: Drugpp 121–225, 1982. indued hyperkalemia. Medicine 64:357–370, 1985.
Rimmer JM, Horn JF, Gennari FJ: Hyperkalemia as a complication of drug therapy. Arch Intern Med 147: 867–869, 1987.
Hultgren HN, Swenson R, Wettach G: Cardiac arrest due to oral potassium administration. Am J Med 58: 139–142, 1975.
McMahon FG, Ryan JR, Akdamar K, Ertan A: Effect of potassium chloride supplements on upper gastrointestinal mucosa. Clin Pharmacol Ther 35: 852–855, 1984.
Alsop WR, Moore JG, Rollins DE, Tolman KE: The effects of five potassium chloride preparations on the upper gastrointestinal mucosa in healthy subjects receiving glycopyrrolate. J Clin Pharmacol 24: 235–239, 1984.
Strom BL, Carson JL, Schinnar R, Sim E, Maislin G, Soper K, Morse L: Upper gastrointestinal tract bleeding from oral potassium chloride. Arch Intern Med 147: 954–957, 1987.
Schwartz AB, Swartz CD: Dosage of potassium chloride elixir to correct thiazide-induced hypokalemia. JAMA 230: 702–704, 1974.
Wan HH, Lye MDW. Moduretic-induced metabolic acidosis and hyperkalaemia. Postgrad Med J 56: 348–350, 1980.
Cohen AB: Hyperkalemic effects of triamterene. Ann Intern Med 65: 521–527, 1966.
Paice B, Gray JMB, McBride D, Donnelly T, Lawson DH: Hyperkalaemia in patients in hospital. Br Med J 286: 1189 1192, 1983.
Mather A, Mackie NR: Effects of hemolysis on serum electrolyte values. Clin Chem 6: 223–227, 1960.
Bronson WR, DeVita VT, Carbone PP, Cotlove E: Pseudohyperkalemia due to release of potassium from white blood cells during clotting. N Engl J Med 274: 369–375, 1966.
Bellevue R, Dosik H, Spergel G, Gussoff BD: Pseudohyperkalemia and extreme leukocytosis. J Lab Clin Med 85: 660–664, 1975.
Stewart GW, Corrall RJM, Fyffe JA, Stockdill G, Strong JA: Familial pseudohyperkalaemia: a new syndrome. Lancet 2: 175–177, 1979.
Graber M, Subramani K, Corish D, Schwab A: Thrombocytosis elevates serum potassium. Am J Kidney Dis 12: 116–120, 1988.
Lum G, Gambino SR: A comparison of serum versus heparinized plasma for routine chemistry tests. Am J Clin Pathol 61: 108–113, 1974.
Ladenson JH, Tsai LB, Michael JM, Kessler G, Joist JH: Serum versus heparinized plasma for eighteen common chemistry tests. Am J Clin Pathol 62: 545–552, 1974.
Hartmann RC, Auditore JV, Jackson DP: Studies on thrombocytosis. I. Hyperkalemia due to release of potassium from platelets during coagulation. J Clin Invest 37: 699–707, 1958.
Kerr DJ, McAlpine LG, Dagg JH: Pseudohyperkalaemia. Br Med J 291: 890–891, 1985.
Don BR, Sebastian A, Cheitlin M, Christiansen M, Schambelan M: Pseudohyperkalemia caused by fist clenching during phlebotomy. N Engl J Med 322: 1290–1292, 1990.
Finch CA, Sawyer CG, Flynn JM: Clinical syndrome of potassium intoxication. Am J Med 1: 337–352, 1946.
Pollen RH, Williams RH: Hyperkalemic neuromyopathy in Addison’s disease. N Engl J Med 263: 273–278, 1962.
Davis JO, Urquhart J, Higgins JT Jr: The effects of alterations of plasma sodium and potassium concentration on aldosterone secretion. J Clin Invest 42: 597–609, 1963.
Fredlund P, Saltman S, Kondo T, Douglas J, Catt KJ: Aldosterone production by isolated glomerulosa cells: modulation of sensitivity to angiotensin II and ACTH by extracellular potassium concentration. Endocrinology 100: 481–486, 1977.
Miller PD, Waterhouse C, Owens R, Cohen E: The effect of potassium loading on sodium excretion and plasma renin activity in Addisonian man. J Clin Invest 56: 346–353, 1975.
van Ypersele de Strihou C: Potassium homeostasis in renal failure. Kidney Int 11: 491–504, 1977.
Gonick HC, Kleeman CR, Rubin ME, Maxwell MH: Functional impairment in chronic renal disease III. Studies of potassium excretion. Am J Med Sci 261: 281–290, 1971.
Perez GO, Pelleya R, Oster JR, Kem DC, Vaamonde CA: Blunted kaliuresis after an acute potassium load in patients with chronic renal failure. Kidney Int 24: 656–662, 1983.
Kahn T, Kaji DM, Nicolis G, Krakoff LR, Stein RM: Factors related to potassium transport in chronic stable renal disease in man. Clin Sci Mol Med 54: 661–666, 1978.
Bergström J, Alvestrand A, Fürst P, Hultman E, WidstamAttorps U: Muscle intracellular electrolytes in patients with chronic uremia. Kidney Int 24 (Suppl 16): S153 — S160, 1983.
Boddy K, King PC, Lindsay RM, Briggs JD, Winchester JF, Kennedy AC: Total body potassium in non-dialyzed and dialyzed patients with chronic renal failure. Br Med J 1: 771–775, 1972.
Widmer B, Gerhardt RE, Harrington JT, Cohen JJ: Serum electrolyte and acid—base composition. The influence of graded degrees of chronic renal failure. Arch Intern Med 139: 1099–1102, 1979.
Restuccio A: Fatal hyperkalemia from a salt substitute. Am J Emerg Med 10: 171–173, 1992.
Sopko JA, Freeman RM: Salt substitutes as a source of potassium. JAMA 238: 608–610, 1977.
Luzi L, Barrett EJ, Groop LC, Ferrannini E, DeFronzo RA: Metabolic effects of low-dose insulin therapy on glucose metabolism in diabetic ketoacidosis. Diabetes 37: 1470–1477, 1988.
DeFronzo RA: Obesity is associated with impaired insulin-mediated potassium uptake. Metabolism 37: 105–108, 1988.
Cohen P, Barzilai N, Lerman A, Hard H, Szylman P, Karnieli E: Insulin effects on glucose and potassium metabolism in vivo: evidence for selective insulin resistance in humans. J Clin Endocrinol Metab 73: 564–568, 1991.
DeFronzo RA: Hyperkalemia and hyporeninemic hypoaldosteronism. Kidney Int 17: 118–134, 1980.
Sunderlin FS, Anderson GH, Streeten DHP, Blumenthal SA: The renin—angiotensin—aldosterone system in diabetic patients with hyperkalemia. Diabetes 30: 335–340, 1981.
Conte G, Dal Canton A, Imperatore P, DeNicola L, Gigliotti G, Pisanti N, Memoli B, Furiano G, Esposito C, Andreucci VE: Acute increase in plasma osmolality as a cause of hyperkalemia in patients with renal failure. Kidney Int 38: 301–307, 1990.
Goldfarb S, Cox M, Singer I, Goldberg M: Acute hyperkalemia induced by hyperglycemia: hormonal mechanisms. Ann Intern Med 84: 426–432, 1976.
Perez GO, Lespier L, Knowles R, Oster JR, Vaamonde CA: Potassium homeostasis in chronic diabetes mellitus. Arch Intern Med 137: 1018–1022, 1977.
Perez GO, Lespier L, Jacobi J, Oster JR, Katz FH, Vaamonde C, Fishman LM: Hyporeninemia and hypoaldosteronism in diabetes mellitus. Arch Intern Med 137: 852–855, 1977.
Arrizabalaga P, Montoliu J, Martinez-Vea A, Andreu L, Lopez-Pedret J, Revert L: Increase in serum potassium caused by beta-2 adrenergic blockade in terminal renal failure: absence of mediation by insulin or aldosterone. Proc Eur Dial Transplant Assoc 20: 572–576, 1983.
Arthur S, Greenberg A: Hyperkalemia associated with intravenous labetabol therapy for acute hypertension in renal transplant recipients. Clin Nephrol 33: 269–271, 1990.
Fletcher GF, Fletcher BJ, Sweeney ME: Effects of exercise testing, training and beta blockade on serum potassium in normal subjects. Am J Cardiol 65: 1242–1245, 1990.
Castellino P, Bia MJ, DeFronzo RA: Adrenergic modulation of potassium metabolism in uremia. Kidney Int 37: 793–798, 1990.
Ericsson F, Carlmark B, Jogestrand T, Sundqvist K: Effect of digoxin upon intracellular potassium in man. Scand J Clin Lab Invest 41: 457–463, 1981.
Bismuth C,. Gaultier M, Conso F, Efthymiou ML: Hyperkalemia in acute digitalis poisoning: prognostic significance and therapeutic implications. Clin Toxicol 6: 153–162, 1973.
Smith TW, Butler VP Jr, Haber E, Fozzard H, Marcus FI, Bremner WF, Schulman IC, Phillips A: Treatment of life-threatening digitalis intoxication with digoxin-specific Fab antibody fragments. N Engl J Med 307: 1357–1362, 1982.
Reza MJ, Kovick RB, Shine KI, Pearce ML: Massive intravenous digoxin overdosage. N Engl J Med 291: 777 778, 1974.
Papadakis MA, Wexman MP, Fraser C, Sedlacek SM: Hyperkalemia complicating digoxin toxicity in a patient with renal failure. Am J Kidney Dis 5: 64–66, 1985.
Evers W, Racz GB, Dobkin AB: A study of plasma potassium and electrocardiographic changes after a single dose of succinylcholine. Can Anesth Soc J 16: 273–281, 1969.
Weintraub HD, Heisterkamp DV, Cooperman LH: Changes in plasma potassium concentration after depolarizing blockers in anaesthetized man. Br J Anaesth 41: 1048–1052, 1969.
Cooperman L: Succinylcholine-induced hyperkalemia in neuromuscular disease. JAMA 213: 1867–1871, 1970.
Brooke MM, Donovan WH, Stolov WC: Paraplegia: succinylcholine-induced hyperkalemia and cardiac arrest. Arch Phys Med Rehab 59: 306–309, 1978.
Greenawalt JW 3rd: Succinylcholine-induced hyperkalemia 8 weeks after a brief paraplegic episode. Anesth Analg 75: 294295, 1992.
Dickerman HW, Walker WG: Effect of cationic amino acid infusion on potassium metabolism in vivo. Am J Physiol 206: 403–408, 1964.
Levinsky NG, Tyson I, Miller RB, Reiman AS: The relation between amino acids and potassium in isolated rat muscle. J Clin Invest 41: 480–487, 1962.
Hertz P, Richardson JA: Arginine-induced hyperkalemia in renal failure patients. Arch Intern Med 130: 778–780, 1982.
Bushinsky DA, Gennari FJ: Life-threatening hyperkalemia induced by arginine. Ann Intern Med 89: 632–634, 1978.
McIvor M, Baltazar RF, Beltran J, Mower MM, Wenk R, Lustgarten J, Salomon J: Hyperkalemia and cardiac arrest from fluoride exposure during hemodialysis. Am J Cardiol 51: 901–902, 1983.
Gabow PA, Kaehny WD, Kelleher SP: The spectrum of rhabdomyolysis. Medicine 61: 141–152, 1982.
Bluemle LW Jr, Webster GD, Elkinton JR: Acute tubular necrosis: analysis of one hundred cases with respect to mortality, complications and treatment with and without dialysis. Arch Intern Med 104: 180–197, 1959.
Grossman RA, Hamilton RW, Morse BM, Penn AS, Goldberg M: Nontraumatic rhabdomyolysis and acute renal failure. N Engl J Med 291: 807–811, 1974.
Gamstorp I, Hauge M, Helweg-Larsen HF, Mjönes H, Sagild U: Adynamica episodica hereditaria. Am J Med 23: 385–390, 1957.
Ptacek LJ, Johnson KJ, Griggs RC: Genetics and physiology of the myotonic muscle disorders. N Engl J Med 328: 482–489, 1993.
Ptacek LJ, George AL Jr, Griggs RC, Tawil R, Kallen RG, Barchi RL, Robertson M, Leppert MF: Identification of a mutation in the gene causing hyperkalemic periodic paralysis. Cell 67: 1021–1027, 1991.
Fontaine B, Khurana TS, Hoffman EP, Bruns GAP, Haines JL, Trofatter JA, Hanson MP, Rich J, McFarlane H, Yasek DM, Romano D, Gusella JF, Brown RH Jr: Hyperkalemic periodic paralysis and the adult muscle sodium channel a-subunit gene. Science 250: 1000–1002, 1990.
Cannon SC, Brown RH Jr, Corey DP: A sodium channel defect in hyperkalemic periodic paralysis: potassium-induced failure of inactivation. Neuron 6: 619–626, 1991.
Streeten DHP, Dalakos TG, Fellerman H: Studies on hyperkalemic periodic paralysis. Evidence of changes in plasma Na and Cl and induction of paralysis by adrenal glucocorticoids. J Clin Invest 50: 142–155, 1971.
Wang P, Clausen T: Treatment of attacks in hyperkalaemic familial periodic paralysis by inhalation of salbutamol. Lancet 1: 221–223, 1976.
Martin RS, Panese S. Virginillo M, Gimenez M, Litardo M, Arrizurieta E, Hayslett JP: Increased secretion of potassium in the rectum of humans with chronic renal failure. Am J Kidney Dis 8: 105–110, 1986.
Hou S, McElroy PA, Nootens J, Beach M: Safety and efficacy of low-potassium dialysate. Am J Kidney Dis 13: 137–143, 1989.
Gennari FJ, Rimmer JM: Disturbances in fluid, electrolyte, and acid-base balance. Part 2. Dialysis patients. In: SG Massry, RJ Glassock, eds, Textbook of Nephrology, 3rd ed. Williams and Wilkins, Baltimore, pp 1434–1440, 1995.
Greenblatt DJ, Koch-Weser J: Adverse reactions to spironolactone. DAMA 225: 40–43, 1973.
Walker BR, Capuzzi DM, Alexander F, Familiar RG, Hoppe RC: Hyperkalemia after triamterene in diabetic patients. Clin Pharmacol Ther 13: 643–651, 1972.
Feinfeld DA, Carvounis CP: Fatal hyperkalemia and hyperchloremic acidosis. DAMA 240: 1516, 1978.
McNay JL, Oran E: Possible predisposition of diabetic patients to hyperkalemia following administration of potassium-retaining diuretic, amiloride (MK870). Metabolism 19: 58–70, 1970.
Atlas SA, Case DB, Sealey JE, Laragh JH, McKinstry DN: Interruption of the renin-angiotensin system in hypertensive patients by captopril induces sustained reduction in aldosterone secretion, potassium retention and natriuresis. Hypertension 1: 274–280, 1979.
Textor SC, Bravo EL, Fouad FM, Tarazi RC: Hyperkalemia in azotemic patients during angiotensin-converting enzyme inhibition and aldosterone reduction with captopril. Am J Med 73: 719–725, 1982.
Bauer JH: Role of angiotensin converting enzyme inhibitors in essential and renal hypertension. Am J Med 77 (Suppl 2A): 43–51, 1984.
Zachariah PK, Bonnet G, Chysant SG, DeBackser G, Goldstein R, Herrera J, Lindner A, Materson BJ, Maxwell MH, McMahon FG, Merrill RH, Paton RR, Rapp AD, Roginsky MS, Seedat YK, Sime F, Vaicaitis JS, Weinberg MS, Zusman RM: Evaluation of antihypertensive efficacy of lisinopril compared to metaprolol in moderate to severe hypertension. J Cardiovasc Pharmacol 9 (Suppl 3): S53 - S58, 1987.
Donohoe JF, Laher M, Doyle GD, Cooper WD: Lisinopril in hypertension associated with renal impairment. J Cardiovasc Pharmacol 9 (Suppl 3): S66 - S68, 1987.
deJong PE, Apperloo AJ, Heeg JE, deZeeuw D: Lisinopril in hypertensive patients with renal function impairment. Nephron 55 (Suppl 1): 43–48, 1990.
Doman K, Perlmutter JA, Muhammedi M, Puschett JB: Life-threatening hyperkalemia associated with captopril administration. South Med J 86: 1269–1272, 1993.
Lewis EJ, Hunsicker LG, Bain RP, Rohde RD: The effect of angiotensin-converting-enzyme inhibition on diabetic nephropathy. N Engl J Med 329: 1456–1462, 1993.
Feig PU, Rutan GH: Angiotensin converting enzyme inhibitors: The end of end-stage renal disease? Ann Intern Med 111: 451–453, 1989.
Praga M, Hernandez E, Montoyo C, Andrés A, Ruilope LM, Rodicio JL: Long-term beneficial effects of angiotensinconverting enzyme inhibition in patients with nephrotic proteinuria. Am J Kidney Dis 20: 240–248, 1992.
Captopril Multicenter Research Group. A placebo-controlled trial of captopril in refractory chronic congestive heart failure. J Am Coll Cardiol 2: 755–763, 1983.
Tan SY, Shapiro R, Franco R, Stockard H, Mulrow PJ: Indomethacin-induced prostaglandin inhibition with hyperkalemia. Ann Intern Med 90: 783–785, 1979.
Clive DM, Stoff JS: Renal syndromes associated with nonsteroidal anti-inflammatory drugs. N Engl J Med 310: 563–572, 1984.
Whelton A, Hamilton CW: Nonsteroidal anti-inflammatory drugs: effects on kidney function. J Clin Pharmacol 31: 588598, 1991.
Rotenberg FA, Giannini VS: Hyperkalemia associated with ketorolac. Ann Pharmacother 26: 778–779, 1992.
Wilson ID, Goetz FC: Selective hypoaldosteronism after prolonged heparin administration. Am J Med 36: 635–640, 1964.
Conn JW, Rovner DR, Cohen EL, Anderson JE Jr: Inhibition by heparinoid of aldosterone biosynthesis in man. J Clin Endocrinol Metab 26: 527–532, 1966.
Busch EH, Ventura HO, Lavie CJ: Heparin-induced hyperkalemia. South Med J 80: 1450–1451, 1987.
Aull L, Chao H, Coy K: Heparin-induced hyperkalemia. DICP Ann Pharmacother 24: 244–246, 1990.
Edes TE, Sunderrajan EV: Heparin-induced hyperkalemia. Arch Intern Med 145: 1070–1072, 1985.
Adu D, Turney J, Michael J, McMaster P: Hyperkalaemia in cyclosporin-treated renal allograft recipients. Lancet 2: 370372, 1983.
Bantle JP, Nath KA, Sutherland DER, Najarian JS, Ferris TF: Effects of cyclosporine on the renin-angiotensinaldosterone system and potassium excretion in renal transplant recipients. Arch Intern Med 145: 505–508, 1985.
Kamel KS, Ethier JH, Quaggin S, Levin A, Albert S, Carlisle EJF, Halperin ML: Studies to determine the basis for hyperkalemia in recipients of a renal transplant who are treated with cyclosporine. J Am Soc Nephrol 2: 1279–1284, 1991.
Bantle JP, Boudreau RJ, Ferris TF: Suppression of plasma renin activity by cyclosporine. Am J Med 83: 59–64, 1987.
Choi MJ, Fernandez PC, Patnaik A, Coupaye-Gerard B, D’Andrea D, Szerlip H, Kleyman TR: Trimethopriminduced hyperkalemia in a patient with AIDS. N Engl J Med 328: 703–706, 1993.
Velazquez H, Perazella MA, Wright FS, Ellison DH: Renal mechanism of trimethoprim-induced hyperkalemia. Ann Intern Med 119: 296–301, 1993.
Lachaal M, Venuto RC: Nephrotoxicity and hyperkalemia in patients with acquired immunodeficiency syndrome treated with pentamidine. Am J Med 87: 260–263, 1989.
Briceland LL, Bailie GR: Pentamidine-associated nephrotoxicity and hyperkalemia in patients with AIDS. DICP 25: 1171–1174, 1991.
Nerup J: Addison’s disease—clinical studies. A report of 108 cases. Acta Endocrinol 76: 127–141, 1974.
Smith SJ, MacGregor GA, Markandu ND, Bayliss J, Banks RA, Prentice MG, Dorrington-Ward P, Wise P: Evidence that patients with Addison’s disease are undertreated with fludrocortisone. Lancet 1: 11–14, 1984.
Yamamoto T, Fukuyama J, Hasegawa K, Sugiura M: Isolated corticotropin deficiency in adults. Arch Intern Med 152: 1705 1712, 1992.
Ross EJ, van’t Hoff W, Crabbe J, Thorn GW: Aldosterone excretion in hypopituitarism and after hypophysectomy in man. Am J Med 28: 229–238, 1960.
Schambelan M, Sebastian A, Biglieri EG: Prevalence, pathogenesis, and functional significance of aldosterone deficiency in hyperkalemic patients with chronic renal insufficiency. Kidney Int 17: 89–101, 1980.
Nadler JL, Lee FO, Hsueh W, Horton R: Evidence of prostacyclin deficiency in the syndrome of hyporeninemic hypoaldosteronism. N Engl J Med 314: 1015–1020, 1986.
Bryan GT, Kliman B, Bartter FC: Impaired aldosterone production in “salt losing” congenital adrenal hyperplasia. J Clin Invest 44: 957–965, 1965.
Ulick S, Eberlin WR, Bliffeld AR, Chu MD, Bongiovanni AM: Evidence for an aldosterone biosynthetic defect in congenital adrenal hyperplasia. J Clin Endocrinol Metab 51: 1346–1353, 1980.
Hamilton W, McCandless AE, Ireland JT, Gray CE: Hypoaldosteronism in three sibs due to 18-dehydrogenase deficiency. Arch Dis Child 51: 576–583, 1976.
Veldhuis JD, Kulin HE, Santen RJ, Wilson TE, Melby JC: Inborn error in the terminal step of aldosterone biosynthesis. N Engl J Med 303: 117–121, 1980.
Braithwaite SS, Barbato AL, Emanuele MA: Acquired partial corticosterone methyl oxidase type II defect in diabetes mellitus. Diabetes Care 13: 790–792, 1990.
Oberfield SE, Levine LS, Carey RM, Bejar R, New MI: Pseudohypoaldosteronism: multiple target organ unresponsiveness to mineralocorticoid hormones. J Clin Endocrinol Metab 48: 228–234, 1979.
Armanini D, Kuhnle U, Strasser T, Dorr H, Butenandt I, Weber PC, Stockigt JR, Pearce P, Funder JW: Aldosteronereceptor deficiency in pseudohypoaldosteronism. N Engl J Med 313: 1178–1181, 1985.
Armanini D, Wehling M, DaDalt L, Zennaro M, Scali U, Keller U, Pratesi C, Mantero F, Kuhnle U: Pseudohypoaldosteronism and mineralocorticoid receptor abnormalities. J Steroid Biochem Mol Biol 40: 363–365, 1991.
Brautbar N, Levi J, Rosler A, Leitesdorf E, Djaldeti M, Epstein M, Kleeman CR: Familial hyperkalemia, hypertension and hyporeninemia with normal aldosterone levels. Arch Intern Med 138: 607–610, 1978.
Schambelan M, Sebastian A, Rector FC Jr: Mineralocorticoid-resistant renal hyperkalemia without salt wasting (type II pseudohypoaldosteronism): role of increased renal chloride reabsorption. Kidney Int 19: 716–727, 1981.
Take C, Ikeda K, Kurasawa T, Kurokawa K: Increased chloride reabsorption as an inherited renal tubular defect in familial type II pseudohypoaldosteronism. N Engl J Med 324: 472–476, 1991.
DeFronzo RA, Cooke R, Goldberg M, Cox M, Myers AR, Agus ZS: Impaired renal tubular potassium secretion in systemic lupus erythematosus. Ann Intern Med 86: 268–271, 1977.
Battle D, Itsarayoungyuen K, Arruda JAL, Kurtzman NA: Hyperkalemic hyperchloremic metabolic acidosis in sickle cell hemoglobinopathies. Am J Med 72: 188–192, 1982.
Batlle DC: Segmental characterization of defects in collecting tubule acidification. Kidney Int 30: 546–554, 1986.
Battle DC, Arruda JAL, Kurtzman NA: Hyperkalemic distal renal tubular acidosis associated with obstructive uropathy. N Engl J Med 304: 373–380, 1981.
Cogan MG, Arieff AI: Sodium wasting, acidosis and hyperkalemia induced by methicillin interstitial nephritis. Am J Med 64: 500–507, 1978.
Chamberlain MJ: Emergency treatment of hyperkalaemia. Lancet 1: 464–467, 1964.
Garcia-Palmieri MR: Reversal of hyperkalemic cardiotoxicity with hypertonic saline. Am Heart J 64: 483–488, 1962.
Ballantyne F III, Davis LD, Reynolds EW Jr: Cellular basis for reversal of hyperkalemic electrocardiographic changes by sodium. Am J Physiol 229: 935–940, 1975.
Blumberg A, Weidmann P, Shaw S, Gnädinger M: Effect of various therapeutic approaches on plasma potassium and major regulatory factors in terminal renal failure. Am J Med 85: 507–512, 1988.
Alton M, Dunlay R, Copkney C: Nebulized albuterol for acute hyperkalemia in patients on hemodialysis. Ann Intern Med 110: 426–429, 1989.
Montoliu J, Lens XM, Revert L: Potassium-lowering effect of albuterol for hyperkalemia in renal failure. Arch Intern Med 147: 713–717, 1987.
Blumberg A, Weidmann P, Ferrari P: Effect of prolonged bicarbonate administration on plasma potassium in terminal renal failure. Kidney Int 41: 369–374, 1992.
Fraley DS, Adler S: Correction of hyperkalemia by bicarbonate despite constant blood pH. Kidney Int 12: 354–360, 1977.
Flinn RB, Merrill JP, Welzant WR: Treatment of the oliguric patient with a new sodium-exchange resin and sorbitol. N Engl J Med 264: 111–115, 1961.
Greenman L, Peters JH, Mateer FM, Danowski TS: Probable clinical utility of cation exchange resins. J Clin Invest 30: 1027–1031, 1951.
Scherr L, Ogden DA, Mead AW, Spritz N, Rubin AL: Management of hyperkalemia with a cation-exchange resin. N Engl J Med 264: 115–119, 1961.
Kramer P, Levitan R: Effect of 9-a-fluorohydrocortisone on the ileal excreta of ileostomized subjects. Gastroenterology 62: 235–241, 1972.
Clarke AM, Hill GL, MacBeth WAAG: Intestinal adaptation to salt depletion in a patient with an ileostomy. Gastroenterology 53: 444–449, 1967.
Evans BM, Hughes-Jones NC, Milne MD, Yellowlees H: Ion-exchange resins in treatment of anuria. Lancet 2: 79 1795, 1953.
Emmett M, Hootkins R, Santa Ana CA, Porter JL, Fordtran JS: Effect of three laxatives and a cation exchange resin on fecal sodium and potassium excretion. Gastroenterology 108: 752–760, 1995.
Lillemoe KD, Romolo JL, Hamilton SR, Pennington LR, Burdick JF, Williams GM: Intestinal necrosis due to sodium polystyrene (Kayexalate) in sorbitol enemas: clinical and experimental support for the hypothesis. Surgery 101: 267–272, 1987.
Wootton FT, Rhodes DF, Lee WM, Fitts CT: Colonic necrosis with kayexelate-sorbitol enemas after renal transplantation. Ann Intern Med 111: 947–949, 1989.
Gerstman BB, Kirkman R, Platt R: Intestinal necrosis associated with postoperative orally administered sodium polystyrene sulfate in sorbitol. Am J Kidney Dis 20: 159–161, 1992.
Berlyne GM, Janabi K, Shaw AB: Dangers of resonium A in the treatment of hyperkalaemia in renal failure. Lancet 1: 167–169, 1966.
Alton M: Treatment and prevention of hyperkalemia in end-stage renal disease. Kidney Int 43: 1197–1209, 1993.
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Gennari, F.J. (1998). Disorders of Potassium Metabolism. In: Suki, W.N., Massry, S.G. (eds) Suki and Massry’s THERAPY OF RENAL DISEASES AND RELATED DISORDERS. Springer, Boston, MA. https://doi.org/10.1007/978-1-4757-6632-5_4
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