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      Trans-Tubular Potassium Gradient in Patients with Drug-Induced Hyperkalemia

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      Nephron

      S. Karger AG

      Trans-tubular potassium gradient, Hyperkalemia, Aldosterone, Drugs

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          Abstract

          Background: Trans-tubular potassium gradient (TTKG) is considered to reflect mainly aldosterone bioactivity with regard to its kaliuretic response. We determined both TTKG and aldosterone serum concentrations in patients with severe drug-induced hyperkalemia (DIH). Methods: Ten hyperkalemic patients with serum potassium of more than 5.5 mEq/l, and serum creatinine of less than 2.5 mg/dl (221 µmol/l) were studied prospectively. Two control groups of 10 patients each were used. Control 1 group with normal renal function, and control 2 group with normokalemia and renal failure of the same magnitude as that of the hyperkalemic patients. Serum osmolarity, electrolytes, creatinine, aldosterone and urine electrolytes and osmolarity were measured and TTKG calculated. Results: DIH patients had lower TTKG values than control 1 patients (2.58 ± 0.36 vs. 6.68 ± 0.55, p < 0.001), and also lower than that of the control 2 patients (2.58 ± 0.36 vs. 5.51 ± 0.87, p < 0.01). Serum aldosterone concentration in the DIH group was higher than that of the control 1 group [24.30 ± 5.0 vs. 7.4 ± 2.1 pg/ml (674 ± 139 vs. 205 ± 58 pmol/l), p < 0.006] but not different from that of the control 2 group [24.3 ± 5.0 vs. 15.3 ± 3.8 pg/ml (674 ± 139 vs. 424 ± 106 pmol/l), respectively, p = 0.18]. Although there was some overlap in TTKG between DIH and control groups, 6 of 10 DIH patients had TTKG of less than 2.5, while none of the control patients had such a low value. Conclusion: DIH is characterized by lower TTKG values than those observed in patients with normal or mild-to-moderate renal failure. Other factors in addition to aldosterone seem to be involved.

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          Author and article information

          Journal
          NEF
          Nephron
          10.1159/issn.1660-8151
          Nephron
          S. Karger AG
          1660-8151
          2235-3186
          2001
          2001
          24 August 2001
          : 89
          : 1
          : 56-61
          Affiliations
          Department of Medicine E, Chaim Sheba Medical Center, Tel Hashomer, and Sackler School of Medicine,Tel-Aviv University, Tel-Aviv, Israel
          Article
          46044 Nephron 2001;89:56–61
          10.1159/000046044
          11528233
          © 2001 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Figures: 2, Tables: 3, References: 17, Pages: 6
          Product
          Self URI (application/pdf): https://www.karger.com/Article/Pdf/46044
          Categories
          Original Paper

          Cardiovascular Medicine, Nephrology

          Hyperkalemia, Aldosterone, Drugs, Trans-tubular potassium gradient

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