Severe acidosis and hyperpotassemia treated with sodium bicarbonate infusion.

H YPERPOTASSEMIA is a serious and often fatal complication of advaniced reiial insufficiency. Its principal lethal action is its depressant effect on the myo(.ardiuin.1 2 In uremia, hyperpotassemia is frequently accompanied by acidosis, hyponatreniia, hypoealeemia, alterations in body water, and changes in cellular imetabolism.3 Correction of these associated electrolyte abn orinalities is often accompanied by improvement in the electroeardiographie manifestations of hyperpotassemia. In the correction of hyperpotasseinia and acidosis with alkali salts, therapeutic success has been achieved with both sodium bicarbonate and sodium lactate. Recently, the latter agent has been the more popular. This report outlines our experience with 4 uremic patients with severe acidosis, hyperpotassemia, and electrocardiographic evidence of advanced cardiac effects. Treatment consisted of the rapid infusion of 5 per cent sodium bicarbonate and, in each case, correction of the acidosis was accompanied by lowering of plasma potassium and reversal of the electrocardiographic signs.