Hyperpotassemia and body water distribution in an anuric child.

C ONSERVATIVE management of anuria has in many instances prolonged life.― This involves the correction of water and electrolyte deficits and the utilization of the protein-sparing effects of glucose to decrease the rate of tissue catabolism. These measures attempt to preserve the integrity of the body fluids, thus retarding the accumu@ lation of toxic substances, i.e., potassium, and reducing the risk of water intoxication and possible pulmonary edema which often results from vigorous fluid, water administration in anuric patients. Attempts to simulate renal excretion by peritoneal lavage,36 gastrointestinal irriga tion,79 exsanguino-transfusion10' “and the artificial kidney technic12'4 seek to maintain homeostasis until there is a return of renal function. Therapy directed at restoration to normal of body water and electrolyte requires knowledge of the normal distribution and of the factors influencing shifts of these substances between the extraand intracellular compartments. The following is a report of clinical observations and studies of body water distribu tion during the course of anuria with progressive hyperpotassemia in a 6 year old child.