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Clinical Disorders of Hyperkalemia

Clinical Disorders of Hyperkalemia Ralph A. DeFronzo, MD., Margaret Bia, MD., and Douglas Smith, MD. Department of Medicine, Yale University School of Medicine, New Haven, Connecticut 06510 Potassium Distribution Total body potassium in a healthy adult is approximately 50 meqlkg body weight or about 3500 meq for a 70-kg man ( 1 , 2). Most of this is located within cells (Figure 1), primarily muscle, at a concentration of about 150 meq/L. Only 2% of total body potassium is located in the extracellular fluid, normally at concentrations of 3.5-5.0 meq/L. The maintenance of this high intracellular to extracellular K concentration depends upon the Na-K ATPase pump (3, 4) as well as other factors, including H+ balance, plasma tonicity, and plasma insulin, epinephrine, and aldosterone concentrations (5). The large difference in potassium concentration across the cell mem­ brane is critical for normal cell function since it is the primary determinant of the resting membrane potential. Small changes in the intracellular/ex­ tracellular K ratio can severely disturb neuromuscular function, particu­ larly of the heart. A gain (or loss) from the extracellular space of an amount of potassium equal to only I % of the total body K content (35 meq) can cause a 50% http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Annual Review of Medicine Annual Reviews

Clinical Disorders of Hyperkalemia

DeFronzo, R A; Bia, M; Smith, D
Annual Review of Medicine , Volume 33 (1) – Feb 1, 1982
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Publisher
Annual Reviews
Copyright
Copyright 1982 Annual Reviews. All rights reserved
Subject
Review Articles
ISSN
0066-4219
eISSN
1545-326X
DOI
10.1146/annurev.me.33.020182.002513
pmid
7044278
Publisher site
See Article on Publisher Site

Abstract

Ralph A. DeFronzo, MD., Margaret Bia, MD., and Douglas Smith, MD. Department of Medicine, Yale University School of Medicine, New Haven, Connecticut 06510 Potassium Distribution Total body potassium in a healthy adult is approximately 50 meqlkg body weight or about 3500 meq for a 70-kg man ( 1 , 2). Most of this is located within cells (Figure 1), primarily muscle, at a concentration of about 150 meq/L. Only 2% of total body potassium is located in the extracellular fluid, normally at concentrations of 3.5-5.0 meq/L. The maintenance of this high intracellular to extracellular K concentration depends upon the Na-K ATPase pump (3, 4) as well as other factors, including H+ balance, plasma tonicity, and plasma insulin, epinephrine, and aldosterone concentrations (5). The large difference in potassium concentration across the cell mem­ brane is critical for normal cell function since it is the primary determinant of the resting membrane potential. Small changes in the intracellular/ex­ tracellular K ratio can severely disturb neuromuscular function, particu­ larly of the heart. A gain (or loss) from the extracellular space of an amount of potassium equal to only I % of the total body K content (35 meq) can cause a 50%

Journal

Annual Review of Medicine – Annual Reviews

Published: Feb 1, 1982

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