J Korean Med Sci.  1993 Feb;8(1):10-16. 10.3346/jkms.1993.8.1.10.

Impaired homeostatic mechanism of potassium handling after acute oral potassium load in diabetes mellitus

• Kim HJ
• Ahn YH
• Park CH
• Kang CM
• Park HC

• KMID: 1421946
• DOI: http://doi.org/10.3346/jkms.1993.8.1.10

Abstract

Chronic stable diabetic patients (n = 6) were compared with healthy control subjects (n = 5) after acute oral intake of 50 mEq of potassium chloride (KCl) to investigate for possible derangements of homeostatic responses for acute term (3 hrs) to acute potassium load. Plasma renin activity (PRA), plasma aldosterone (PA), and transtubular potassium concentration gradient (TTKG) known as a useful semiquantative index of distal nephron potassium secretion were measured. All the baseline parameters were comparable between diabetic and non-diabetic subjects except for significantly reduced creatinine clearance in diabetics (mean +/- SEM, 105 +/- 4 vs. 85 +/- 5 ml/min, p < 0.05). Following acute oral KCl load, the peak increases of serum potassium changes from basal levels were noted at 2 hours in both groups, but were higher in diabetic subjects (mean +/- SEM, 0.42 +/- 0.06 vs. 0.62 +/- 0.09 mEq/L). Also, 4 out of 6 diabetic subjects but none of the control subjects at 2 hours after oral KCl load became hyperkalemic ( > 5.0 mEq/L). PRA did not show any significant changes, whereas PA was increased simultaneously with increments in serum potassium in both groups, with blunted increases in the diabetics. However, TTKG was increased prominently in control subjects (8.18 from 4.98), but only slightly in diabetic subjects (4.55 from 4.18), with statistical difference between the two groups (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Keyword

Potassium; Homeostasis; Transtubular Potassium Concentration Gradient; Renal Insufficiency; Diabetes Mellitus

MeSH Terms

Adult
Aged
Aldosterone/blood
Diabetes Mellitus, Type 2/*metabolism
*Homeostasis
Humans
Kidney Tubules/metabolism
Male
Middle Aged
Potassium/*metabolism
Renin/blood
Aldosterone
Potassium
Renin