Treatment of Cardiac Sensitivity to Hyperkalemia with Aldosterone,Renin,or Insulin 1

Abstract

Summary

In pancreatectomized or ne-phrectomized dogs K⁺-loading by infusion of 2 mEq KCl/kg/hr produces ECG evidence of prelethal hyperkalemic cardiotox-icity when serum K⁺ reaches about 10 mEq/ liter. If, however, the operations are combined and the KC1 infused into nephrecto-mized-pancreatectomized animals, there is a highly significant increase in cardiac sensitivity to hyperkalemia; prelethal ECG changes appear when mean serum K⁺ is ∼7.7 mEq/liter (P < 0.001), a level almost identical with that found in dogs loaded with K⁺ 4 hr after bilateral adrenalectomy. Treatment of nephrectomized-pancreatectomized dogs with aldosterone, renin, or insulin decreases cardiac sensitivity to K⁺ and raises the prelethal cardiotoxic level of serum K⁺ to the range found in controls. The results suggest the possibility of a role for insulin in stimulation of aldosterone secretion by KC1 infusion.