Renal Excretion of Potassium

Clifton K. Meador, MD
JAMA. 1968;206(4):895-896. doi:10.1001/jama.1968.03150040107032.
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To the Editor:—  W. D. Snively, MD, in a recent editorial entitled "An Example of Atavistic Physiology?," expressed opinions concerning the appropriateness of the renal mechanism for handling sodium and potassium (204:392, 1968). While it is unlikely that this or any discussion will change the order of things, his statement that civilized man's present pattern has outlasted its usefulness can be questioned.Dr. Snively states that man's kidney can conserve sodium avidly, but, that it wastes potassium. This is only when the intake of the ions is brought virtually to zero. From results of experiments of extreme deprivation, he extrapolates to conclude, "Clearly, the body manifests an inappropriate, even damaging, pattern of hoarding sodium and wasting potassium." Under conditions usually met in nature, these renal responses to sodium or potassium withdrawal are quite appropriate and life saving. The extracellular space with its life-maintaining plasma volume is appropriately protected by


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