Smoller S, Rashid K, Perez G O, Oster J R, Vaamonde C A
Medical Service, Veterans Administration Medical Center, Miami, FL 33123.
Am J Med Sci. 1988 Feb;295(2):114-21. doi: 10.1097/00000441-198802000-00005.
It is unknown whether diabetic patients without renal failure or aldosterone deficiency respond normally to potassium administration. Acute oral potassium-loading was carried out in eight diabetic patients with modestly reduced creatinine clearance (Ccr) and in 11 diabetic patients and 13 controls with normal clearances. Only one diabetic patient manifested an inappropriately low upright plasma aldosterone level (6 ng/dL). The percentage of potassium excreted in 4 hour by both groups of diabetic patients was significantly less than that of the controls (decreased Ccr:21% +/- 6%, normal Ccr:36% +/- 5%, controls:54% +/- 5%; p less than 0.01 and 0.05 respectively). On the other hand, the estimated amount of potassium translocated intracellularly tended to be greater in the diabetic patients (18 +/- 3 mmol; 11 +/- 3 mmol) than controls(7 +/- 2 mmol; p less than 0.005 and 0.1 respectively), and the ratio of the increase in plasma (K) to the amount of potassium retained, was lower in diabetic patients, probably indicating enhanced intracellular potassium translocation. The authors conclude that diabetic patients with normal or only slightly reduced renal function (and no aldosterone deficiency) may have a reduced capacity to excrete an acute potassium load but an enhanced capacity to transfer potassium intracellularly.
尚无肾功能衰竭或醛固酮缺乏的糖尿病患者对钾摄入的反应是否正常的相关研究。对8名肌酐清除率（Ccr）轻度降低的糖尿病患者、11名Ccr正常的糖尿病患者及13名健康对照者进行了急性口服钾负荷试验。仅1名糖尿病患者出现直立位血浆醛固酮水平异常降低（6 ng/dL）。两组糖尿病患者4小时内钾排泄百分比均显著低于对照组（Ccr降低组：21%±6%，Ccr正常组：36%±5%，对照组：54%±5%；p分别<0.01和<0.05）。另一方面，糖尿病患者细胞内钾转运量估计值（18±3 mmol；11±3 mmol）倾向于高于对照组（7±2 mmol；p分别<0.005和<0.1），且糖尿病患者血浆钾升高量与钾潴留量的比值较低，这可能表明细胞内钾转运增强。作者得出结论，肾功能正常或仅轻度降低（且无醛固酮缺乏）的糖尿病患者排泄急性钾负荷的能力可能降低，但细胞内钾转运能力增强。
