The clinical management of renal failure continues to become more hopeful, despite a lag in an understanding of the pathogenesis of many signs and symptoms of uremia. Downward revision of the water requirement of the anuric patient has obviated lethal overhydration; more general familiarity with abnormalities of electrolyte metabolism has rendered distortion of extracellular electrolytes by renal failure more amenable to exact diagnosis and correction; and improvement of the uremic patient's condition has followed skillful utilization of extracorporeal dialysis, even though it is not apparent why the patient's betterment follows removal by dialysis of such a host of small organic and inorganic substances. Gains such as these allow us to restore health to more patients with acute renal failure and to relieve symptoms and prolong life in patients suffering from chronic uremia.
Hyperkalemia nevertheless continues to be a common lethal event in uremia. This is disturbing, since its occurrence is