DAVID A. NARDONE, M.D.
To the editor: Aldinger and Samaan in their article "Hypokalemia with Hypercalcemia" (Ann Intern Med 87:571-573, 1977) demonstrate a higher prevalence of hypokalemia in the hypercalcemia of malignancy than in that of hyperparathyroidism. They postulate that this difference is due to decreased potassium intake either from the malignancy itself or associated chemotherapy as well as gastrointestinal losses. I suggest two additional mechanisms.
The first is related to the metabolic effects of parathormone (1). Parathormone promotes renal bicarbonate wasting, renal reabsorption of hydrogen ion, and production of organic acids. As a consequence, in hypercalcemia from primary hyperparathyroidism there is a tendency
NARDONE DA. Hypokalemia and Hypercalcemia. Ann Intern Med. ;88:270. doi: 10.7326/0003-4819-88-2-270_1
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Published: Ann Intern Med. 1978;88(2):270.
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