STUDY OF THE POTASSIUM METABOLISM AND THE SECOND HEART SOUND IN ACUTE GLOMERULONEPHRITIS

PART 1. STUDY UPON POTASSIUM METABOLISM IN ACUTE GLOMERULONEPHRITIS

Abstract

Fifteen cases of acute glomerulonephritis are reported, in ten of which hyperpotassemia over 5.8mEq/L was transiently noted. In the course of acute nephritis, hyperpotassemia appeared from 5 to 32 days (average: 16 days) after the onset of edema and serum potassium rose to the highest level from 13 to 32 days (average: 21 days) after the onset of the edema.
Hyperpotassemia persisted from several to 20 days in nine cases.
Serum potassium rose to the highest level from 4 to 21 days after the onset of diuresis, approximately corresponding to the stage of complete loss of excess body weight. In 7 of the 15 cases, the stage of hyperpotassemia coincided with that of increased out put of K in the urine. In other cases the stage of increase in out put of K was preceded or followed by hyperpotassemia.
The kidney function as shown by creatinine or urea clearance and P. S. P. test in the recovery stage of acute nephritis, during which hyperpotassemia due to transient elevation of serum K is observed, revealed improvement when compared with that of the early stage of acute nephritis.
In the recovery stage with trasient hyperpotassemia, the out put of K in the urine was increased along with diuresis. The author considers that hyperpotassemia is invited when the transference of K from the cells or tissues into vessels exceeds the loss of K from the kidneys.