- 1.1. Electrocardiograms and blood samples for simultaneous chemical analyses were taken from nineteen patients with severe renal insufficiency. Similar studies were made in five patients with diminished and, subsequently, normal concentrations of serum potassium.
- 2.2. Electrocardiographic findings referable to the toxic effect of potassium were observed in four of the patients with renal insufficiency when the concentration of serum potassium was elevated. These findings were not observed when the concentration of serum potassium was normal.
- 3.3. The range of concentration of serum potassium within which associated electrocardiographic disturbances sometimes occurred was 6.8 to 7.6 mEq./L. These disturbances were present consistently at concentrations greater than 7.8 mEq./L. At a given elevated concentration of serum potassium the appearance of the electrocardiogram varied widely.
- 4.4. The most characteristic changes associated with hyperkaliemia in this series were peaked T waves and increase in the duration of the QRS complex. Low amplitude of the T wave and prolonged electrical systole were the most frequent findings in the group with hypokaliemia.
- 5.5. In three of the five patients elevation of the concentrations of serum potassium to normal values did not ameliorate the electrocardiographic disturbances which presumably resulted from low concentrations.
- 6.6. Implications of the present study for the problem of the use of potassium in treatment have been discussed.
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☆This work was done during the tenure of a Life Insurance Medical Research Fellowship.