Depletion of body potassium by diuretics.

THE occurrence of ulcers in the small intestine during the course of treatment of patients with thiazide diuretics together with enteric-coated tablets of potassium chloride or enteric-coated tablets of combinations of thiazides and potassium chloride has suggested to several investigators that some factor in these medications may be responsible for the genesis of such ulcers.1' 2 As a matter of fact, some authors have recommended that the administration of enteric-coated tablets be discontinued.3 These considerations may lead some physicians to neglect the need for continued careful evaluation of patients, receiving diuretic therapy, for manifestations of potassium deficiency. The purpose of this report is to (1) illustrate the rapidity with which potassium deficits may develop in patients during administration of combinations of diuretics to these patients, and (2) the usefulness of body composition measurements in clinical medicine. The data reported here were obtained during the course of a study designed to test the hypothesis that the hypokalemia associated with the administration of thiazide diuretics reflects a redistribution of potassium rather than a depletion of body potassium. Hollander and associates,4 have reported that 4 to 8 weeks of chlorothiazide administration to hypertensive patients produced a significant decrease in the exchangeable potassium content of these patients. Talso and