Abstract
The intracellular potassium content of leukocytes, the extracellular fluid volume (82Br space), and exchangeable potassium were determined in 28 patients with cirrhosis of the liver (18 with ascites) and in 15 hospitalized controls. No intracellular potassium depletion could be identified in these patients. Leukocyte potassium was similar in cirrhotic patients with and without ascites (355.9±25.3 and 348.1±31.9 mEq/kg of dry solids, respectively) and in hospitalized controls (359.7±27.4) (mean±sd). The extracellular fluid volume was similar in controls and cirrhotics without ascites, but markedly increased in cirrhotics with ascites. The exchangeable potassium (mEq/kg of body weight) was similar in nonascitic cirrhotics and in hospitalized controls, but significantly lower in patients with cirrhosis and ascites. However, when the estimated weight of the extracellular fluid volume was substrated from the total body weight, thus obviating the influence of the increased extracellular fluid volume of ascitic patients in the body weight, the exchangeable potassium (mEq/kg of “corrected” body weight) was similar in cirrhosis with ascites (52.9±6.7 mEq/kg), nonascitic cirrhotics (55.8±6.1 mEq/kg) and hospitalized controls (55.0±8.3 mEq/kg), and a significant correlation was obtained between the exchangeable potassium and the leukocyte potassium content. In five patients, the measurements were repeated after relieving ascites with diuretics. No change was observed in the leukocyte potassium, but exchangeable potassium (mEq/kg of body weight) increased, reaching values not significantly different from controls or nonascitic cirrhotics. The exchangeable potassium (mEq/kg of “corrected” body weight) did not change. Our results strongly suggest that potassium depletion was not present in the series of cirrhotic patients studied.
Similar content being viewed by others
References
Mas A, Piera C, Bosch J, Arroyo V, Roca M, Rodés J: Evidence that potassium depletion does not occur in cirrhosis with ascites. Digestion 14:467, 1976
Casey TH, Summerskill WHJ, Orvis AL: Body and serum potassium in liver disease. I. Relationship to hepatic function and associated factors. Gastroenterology 48:198–207, 1965
Nagant de Deuxchaisnes C, Collet RA, Busset R, Mach RS: Exchangeable potassium in wasting, amyotrophy, heart disease, and cirrhosis of the liver. Lancet 1:681–687, 1961
Roberti A, Traverso H, Vesin P, Viguié R, Blanchon P: Etude du Na et du K échangeables et des liquides extracellulaires dans les cirrhoses éthyliques. Sem Hop Paris 42:1714–1718, 1966
Vesin P: Water, electrolyte and acid-base disorders in liver disease.In Clinical Disorders of Fluid and Electrolyte Metabolism, 2nd ed. MH Maxwell, CR Kleeman (eds). New York, McGraw-Hill, 1972, pp 873–895
Casey TH, Summerskill WHJ, Bickford RG, Rosevear JW: Body and serum potassium in liver disease. II. Relationships to arterial ammonia, blood pH, and hepatic coma. Gastroenterology 48:208–215, 1965
Podolsky S, Zimmerman HJ, Burrows BA, Cardarelli JA, Pattavina CG: Potassium depletion in hepatic cirrhosis. A reversible cause of impaired growth-hormone and insulin response to stimulation. N Engl J Med 288:644–648, 1973
Kessler E, Levy MR, Allen RL Jr: Red cell electrolytes in patients with edema. J Lab Clin Med 57:32–41, 1961
Astrup J, Prytz H, Thomsen AC, Westrup M: Red cell sodium and potassium contents in liver cirrhosis. Gastroenterology 78:530–534, 1980
Strub IH, Talso PJ, Kirsner JB: Intracellular and extracellular fluid and electrolyte alterations in cirrhosis of the liver with edema and ascites. Gastroenterology 28:163–175, 1955
Maschio G, D'Angelo A, Sirigu F, Ossi E, Doliu R, Fagiolo V, Naccarato R: Muscle biopsy studies in liver cirrhosis. Scand J Gastroenterol 6:363–368, 1971
Roberts PM, Baron DN: Leukocyte assay as a measure of intracellular water, sodium and potassium in chronic hepatic failure and chronic renal failure. Clin Sci 25:351–355, 1963
Baron DN, Ahmed SA: Intracellular concentrations of water and of the principal electrolytes determined by analysis of isolated human leukocytes. Clin Sci 37:205–219, 1969
Patrick J, Bradford B: A comparison of leukocyte potassium content with other measurements in potassium depleted rabbits. Clin Sci 42:415–421, 1972
Patrick J, Jones NF: Cell sodium, potassium and water in uraemia and the effect of regular dialysis as studied in the leukocyte. Clin Sci Mol Med 46:583–590, 1974
Edmonson RPS, Thomas RD, Hilton PJ, Patrick J, Jones NF: Leukocyte electrolytes in cardiac and non-cardiac patients receiving diuretics. Lancet 1:12–14, 1974
Alam AN, Wilkinson SP, Poston L, Moodie H, Williams R: Intracellular electrolyte abnormalities in fulminant hepatic failure. Gastroenterology 72:914–917, 1977
Patrick J, Golden M: Leukocyte electrolytes and sodium transport in protein energy malnutrition. Am J Clin Nutr 30:1478–1481, 1977
Veall N, Vetter H: Radioisotope Techniques in Clinical Research and Diagnosis. London, Butterworth, 1958, pp 191–194
Howe CT, Ekins RP: The bromide space after the intravenous administration of82Br. Br J Nucl Med 4:469–476, 1963
McMurray JD, Boling EA, Davis JM, Parker HV, Magnus IC, Ball MR, Moore FD: Body composition: Simultaneous determination of several aspects by the dilution principle. Metabolism 7:651–667, 1958
Black DAK: Potassium metabolism.In Clinical Disorders of Fluid and Electrolyte Metabolism, 2nd ed. MH Maxwell, CR Kleeman (eds). New York, McGraw-Hill, 1972, pp 121–149
Conn HO: Cirrhosis.In Diseases of the Liver, 4th ed. L Schiff (ed). Philadelphia, JB Lippincott Company, 1975, pp 833–939
Delwaide PA: Body potassium measurements by whole-body counting: Screening of patient populations. J Nucl Med 14:40–48, 1973
Roginski MS, Zanki I, Cohn SH: Skeletal and lean body mass in alcoholics with and without cirrhosis. Calcified Tissue Res 21(suppl):386–391, 1976
Soler NG, Jain S, James H, Paton A: Potassium status of patients with cirrhosis. Gut 17:152–157, 1976
Birkenfeld LW, Leibman J, O'Meara MP, Edelman IS: Total exchangeable sodium, total exchangeable potassium, and total body water in edematous patients with cirrhosis of the liver and congestive heart failure. J Clin Invest 37:687–698, 1958
Schober O, Mario P, Schmidt FW, Hundeshagen H: Total body water, extracellular water, plasma volume and total body potassium in cirrhosis of the liver. Klin Wochenschr 57:757–761, 1979
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Mas, A., Bosch, J., Piera, C. et al. Intracellular and exchangeable potassium in cirrhosis. Digest Dis Sci 26, 723–727 (1981). https://doi.org/10.1007/BF01316862
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01316862