Karsten, M. (2020) The acute effect of an oral K+-load on the K+- and Na+-balance in healthy subjects. thesis, Medicine.
Full text available on request.Abstract
It is unknown if the risk of hyperkalemia outweighs the beneficial effects of a potassium (K+) rich diet in chronic kidney disease (CKD). First it is necessary to gain insight in the acute internal K+ balance in healthy subjects following a K+-load, to be able to establish if it is save to recommend a K+-rich diet in CKD. The beneficial effect of K+ depends partly on the natriuretic effect and in this context knowledge of the sodium (Na+) balance is of interest. In this single-centre placebo-controlled double-blind interventional cross-over study 40 mmol Kchloride (KCl) and Kcitrate with and without renin-angiotensin-aldosterone inhibition (RAASi) and a placebo were administered. The 4 hours following the supplement red blood cell (RBC) [K+] and plasma and urine [K+] and [Na+] were closely monitored. A substantial part of the K+-load was excreted in urine, a slight part was buffered in plasma and at 2 hours 55% (95% confidence interval (95%CI): 46% to 65%) was buffered intracellular and interstitial. Followed by K+ efflux and at 4 hours 43% (95%CI: 25% to 62%) remained buffered. The Nguyen-Kurtz and Barsoum-Levine formulas showed an ongoing effect of buffered K+ on cation balance between 2-4 hours after a K+-load. The K+-load provoked initial natriuresis and after 2 hours 18 (95%CI: 13 to 23) mmol efflux of Na+ occurred. Body Cell Mass (BCM) was positively correlated to K+ influx. RBC [K+] did not change. RAASi and the accompanying anion had a minor effect on K+ balance. Acute K+ homeostasis following a K+-load relies both on initial influx of K+ to intracellular and interstitial and an ongoing renal excretion of K+. This is initially accompanied by counterbalancing efflux of Na+ and natriuresis. Possibly osmotically inactive buffering of K+ has an ongoing effect on the cation excretion.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | prof. dr. de Borst, M.H. and MD PhD Vogt, L. and MSc Wouda, R.D. |
| Faculty: | Medical Sciences |
| Date Deposited: | 29 Nov 2023 12:33 |
| Last Modified: | 29 Nov 2023 12:33 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3729 |
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