Hypokalemia: are elderly females more vulnerable?

This study was undertaken to evaluate the relationship between prevalence of hypokalemia and the age and sex of patients. Serum potassium concentrations of 872 patients were measured, and the prevalence of hypokalemia was compared between age and sex groups. Hypokalemia was more common in patients 65 years or older than in younger groups (P < .001), with a significantly higher frequency in female patients (P < .003). The finding was more common in elderly female patients than in elderly males (P < .002). No statistically significant difference was noted in the frequency of hypokalemia in elderly male patients compared with younger patients of either sex. The predominance of hypokalemia in elderly groups was chiefly attributable to a marked preponderance in elderly female patients over all other groups. Neither younger females nor elderly males were at increased risk. The preponderance in elderly females was not dependent on diuretic usage. It may have been due to age- and sex-associated differences in body mass composition, which result in a physiologically low total exchangeable body potassium in elderly females, placing this group at greater risk for developing hypokalemia.

Giant peptic ulcers in patients with chronic renal failure.

The clinical characteristics and outcome of patients with peptic ulcer disease (PUD) in association with chronic renal insufficiency were compared with those of patients who had PUD without renal impairment. The number of patients hospitalized with PUD was 150, which represented 1.3% of all hospital admissions to Kingsbrook Jewish Medical Center over the two-year period August 1986 to August 1988. The incidence of PUD among the patients with end-stage renal disease was 2.6%. Mortality was significantly higher in patients with serum creatinine greater than 264 mumol/L (Group A) than in patients with serum creatinine less than 264 mumol/L (Group B) (p = 0.02). A striking finding was the presence of giant (greater than 2 cm in width) gastric and duodenal ulcers and ulcers of the second portion of the duodenum in both groups. The difference in number of giant ulcers in Group A and Group B was statistically significant (p less than 0.001). Moreover, the patients in Group A had a higher incidence of upper gastrointestinal bleeding and mortality than those in Group B. Group A patients also had a greater need for surgery than Group B patients. Both groups were predominantly elderly with a mean age greater than 65 years, which may have contributed to the increased incidence of complications and mortality.