[Studies on the pathophysiology of the Fanconi syndrome in adults].
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Biomedical subjects
Publications and source records attributed to H J Kramer.
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Following a short review of the physiological regulation of body potassium diagnostic procedures to detect disturbances in potassium balance are cited. The limited value of serum potassium concentration is emphasized. Possible caused of potassium deficiency and prophylactic measures to prevent negative potassium balance are summarized including oral and parenteral potassium administration. A synopsis of the causes of hyperkalemia is followed by a description of therapeutical measures. Chronic hyperkalemia may be treated by oral or rectal administration of ion-exchange resins, while acute lifethreatening hyperkalemia is corrected by infusion of isotonic saline, glucose and insulin, and calcium gluconate as well as by correction of metabolic acidosis with sodium bicarbonate. In patients with intact renal function these measures will generally result in rapid correction of increased serum potassium levels.
Body electrolyte and water balance as well as elimination of toxic metabolites depend on intact renal function. Acute azotemia of either prerenal, renal, or postreanal origin requires adequate fluid and electrolyte theraphy. Based on physiological regulation of protein metabolism and nitrogen balance parenteral nutrition of uremic patients with stable renal function is described. Sufficient caloric supplementation is required. Parenteral treatment to improve nitrogen balance in these patients is achieved by infusion of essential amino acids including histidine. The possible therapeutic value of keto-analogs is suggested by recent studies.
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