The Role of the Artificial Kidney in Correcting Serum Electrolyte Abnormalities in Renal Failure

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AT the Cleveland Clinic Hospital, from January 1,1957, to September 20, I960, a total of 651 dialyses was performed on 258 patients with either acute or chronic renal failure. The Kolff disposable twin-coil artificial kidney was used. Often, the correction of serum electrolyte abnormalities was either a primary or a secondary reason for initiating dialysis. Table 1 shows the number of patients in whom the serum electrolyte concentrations were either abnormally high or low before dialysis. The possibility of correcting the electrolyte abnormalities with the artificial kidney is well known. Table 2 summarizes the results1,2 of the 64 first dialyses performed for acute renal failure in 1957 and 1958. Serum potassium values were within normal limits after 63 of the 64 dialyses. When serum electrolyte values did not return to within the normal range during the first dialysis, they usually did so, after the second or third dialysis.

Four representative case reports are presented to illustrate the effectiveness of the disposable twin-coil artificial kidney in correcting electrolyte abnormalities in patients with renal failure. Since each patient had multiple abnormalities in the serum electrolytes, the one or two outstanding deviations are indicated for each case.

Four Representative Case Reports

Case 1. High serum potassium and low serum carbon dioxide content. A 15-year-old boy was admitted to the Cleveland Clinic Hospital because of progressive weakness, oliguria, and generalized edema that developed six weeks before admission. For the past year he had a backache and had also lost 40 pounds in weight. Two . . .