Potassium Deficiency in Chronic Renal Disease

IN N RECENT years much attention has been directed to the occurrence of potassium intoxication in renal disease.1Reports of intolerance to potassium in renal insufficiency2have contributed to the general impression that patients with damaged kidneys have decreased capacity to rid the body of potassium, that there is thus "retention" of potassium and that the patient with terminal renal disease dies as the result of cardiac intoxication secondary to hyperpotassemia. It would appear, however, that derangement of potassium metabolism in renal disease will commonly result in the occurrence of potassium deficiency. It is true that some patients with advanced renal insufficiency may have an elevated serum potassium concentration and certain of these patients will demonstrate clinical or electrocardiographic evidence of potassium intoxication.3Many patients, however, will have normal or near-normal serum levels despite evidence of severe renal disease, and, indeed, this has been the more usual