NANCY E. GARY, M.D.; ROBERT P. EISINGER, M.D.
To the editor: We read with interest the article on clay ingestion as a cause of hypokalemia by Gonzalez and colleagues (1). The data presented certainly suggest that clay acts to bind potassium in vitro. But in the absence of measured urinary electrolytes, a mineralocorticoid-like effect of the clay or other concurrently ingested agent cannot be excluded. Ammonium glycyrrhizate is an ingredient of natural licorice and some chewing tobaccos, and causes sodium retention, potassium loss, and suppression of the renin-angiotensin-aldosterone axis (2).
Without knowledge of the patient's dietary intake or urinary excretion of sodium, the plasma renin value is difficult
GARY NE, EISINGER RP. Clay Ingestion and Hypokalemia. Ann Intern Med. ;97:622. doi: 10.7326/0003-4819-97-4-622_2
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Published: Ann Intern Med. 1982;97(4):622.
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