Early and late adjustment to potassium loading in humans

TJ Rabelink, HA Koomans, RJ Hené, EJD Mees - Kidney international, 1990 - Elsevier
TJ Rabelink, HA Koomans, RJ Hené, EJD Mees
Kidney international, 1990Elsevier
Early and late adjustment to potassium loading in humans. We studied the adaptation to
early (72 hr) and late (20 days) K loading (400 mmol/day, 4 equal meals every 6 hour) in six
healthy humans. Throughout the study, each single K meal was followed by an acute
transient rise in plasma K, aldosterone and kaliuresis.“K balance”(urinary K excretion∼ 80%
of intake) was achieved in the second 24 hour period of K loading. This was associated with
elevated plasma K and aldosterone, slightly negative sodium (Na) balance and stimulated …
Early and late adjustment to potassium loading in humans. We studied the adaptation to early (72 hr) and late (20 days) K loading (400 mmol/day, 4 equal meals every 6 hour) in six healthy humans. Throughout the study, each single K meal was followed by an acute transient rise in plasma K, aldosterone and kaliuresis. “K balance” (urinary K excretion ∼80% of intake) was achieved in the second 24 hour period of K loading. This was associated with elevated plasma K and aldosterone, slightly negative sodium (Na) balance and stimulated plasma renin activity. At 20 days of K loading Na loss had been compensated. Plasma renin activity and aldosterone had returned to baseline, although the latter kept increasing after each single K meal. Compared to the first K meal, the K meals at 72 hours and 20 days of K loading were followed by more kaliuresis, while the natriuretic effect had disappeared. Abrupt discontinuation of K loading was followed by negative K balance, lasting only 24 hour, and by Na retention, lasting 72 hours. In conclusion, switching to a high K diet in humans is immediately followed by increased renal K excretion, and by Na loss. K excretion increases over a few days, while Na loss is halted. This can be explained by the rise in plasma aldosterone, secondary to elevated plasma K and renin activity. After weeks, renal adaptation forms an additional factor promoting K excretion and preventing natriuresis. The latter appears specifically from the Na retention which occurs after discontinuation of K loading in the absence of persistent aldosterone stimulation.
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