慢性腎疾患における腎のカリウム処理機構に関する臨床ならびに実験的研究
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It seems clear that potassium metabolism may be disturbed in the presence of renal disease. The variation of serum potassium in chronic renal diseases were analysed on the aspect of the renal ability to excrete potassium, and the renal mechanisms of potassium excretion were researched in experimental animals. The results obtained are summarized as follows. The concentration of serum potassium in chronic renal diseases were observed to be mostly within the normal range. The considerable variation in values for serum potassium appeared in chronic renal insufficiency, but among patients who have similar high degree of chronic renal lesion, the values of serum potassium were increased in some and normal or even subnormal in others. But it is evident that the content of potassium in the serum may become abnormally high not only at the terminal phase but in many cases with renal insufficiency below GFR 30ml/min. In these cases of renal insufficiency, TRFk were found to be fall, on the other hand the values of potassium clearance were decreased. Therefore, the renal abilities to excrete and support potassium were both disturbed in these cases. The concentration of urine potassium in renal insufficiency were usually fixed to be dilute, including diurnal and daily and when the hypertonic solutions were loaded. Therefore, the appearances of the abnormalities of serum potassium in chronic renal failures were influenced by the amount of their volumes of urine. In several cases with severe renal failure excreted potassium in urine exceeded the amount that was filtered, suggesting of tubular secretion of potassium. In dogs loading potassium with similar pathologic condition to these clinical cases, the renal mechanism of potassium excretion were analysed by clearance methods, including the loading of several hypertonic solutions and stop-flow method. The observation might give a result that urinary excreted potassium : glomerular filtered potassium ratio was greater than unit, indicating secretion of potassium from proximal tubule. In dog loading potassium with experimentally produced lesion of the proximal tubules, similar data to the pattern of urinary potassium excetion in clinical observations was obtained.
- 千葉大学の論文
- 1966-07-28
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