Bock K D, Cremer W, Werner U
Klin Wochenschr. 1978;56 Suppl 1:91-6. doi: 10.1007/BF01477459.
Description of 23 patients (21 women, 2 men) with an average age of 36.6 (19--68) years, who were hypokalemic during 6.5 years on the average (range 1/2--16 years). The cause of the potassium depletion was malnutrition (anorexia nervosa, vomiting) and/or abuse of laxatives and/or diuretics. With increasing duration of potassium depletion renal function deteriorated; in two cases terminal renal failure developed. Histology of the kidneys (9 cases) showed the picture of chronic abacterial interstitial nephritis. Urinalysis was negative or non-specific. The blood pressure levels were normal or low, hypertensive values being exceptional. Aside of hypokalemia a tendency to hyponatriemia, hypochloremia and metabolic alcalosis was observed, the latter turning into hypokalemic normochloremic acidosis with advancing renal insufficiency. Plasma renin activity and aldosterone concentration or excretion frequently were elevated, but no close correlation was found between these parameters or with the blood pressure. Bacterial infection of the urinary tract occured, if at all, in the late phase and seems to be complication rather than the cause of the kidney disease. The discussion of other possible pathogenetic factors leads to the conclusion that the term "chronic kaliopenic nephropathy" is justified. Some diagnostic and therapeutic consequences are mentioned.
描述了23例患者（21名女性，2名男性），平均年龄36.6岁（19 - 68岁），平均6.5年（范围1/2 - 16年）处于低钾血症状态。钾缺乏的原因是营养不良（神经性厌食、呕吐）和/或滥用泻药和/或利尿剂。随着钾缺乏持续时间的增加，肾功能恶化；2例发展为终末期肾衰竭。肾脏组织学检查（9例）显示为慢性无菌性间质性肾炎。尿液分析为阴性或非特异性。血压水平正常或偏低，高血压值罕见。除低钾血症外，还观察到低钠血症、低氯血症和代谢性碱中毒倾向，随着肾功能不全进展，后者转变为低钾性正常氯性酸中毒。血浆肾素活性和醛固酮浓度或排泄量经常升高，但这些参数之间或与血压之间未发现密切相关性。尿路感染如果发生，多在晚期，似乎是肾脏疾病的并发症而非病因。对其他可能的致病因素进行讨论后得出结论，“慢性低钾性肾病”这一术语是合理的。文中提到了一些诊断和治疗方面的结论。
