Potassium ion is necessary for the function of all living cells, and is thus present in all plant and animal tissues. It is found in especially high concentrations in plant cells, and in a mixed diet, it is most highly concentrated in fruits.
In many respects, potassium and sodium are chemically similar, although they have very different functions in organisms in general, and in animal cells in particular.
Biochemical functionPotassium cations are important in neuron (brain and nerve) function, and in influencing osmotic balance between cells and the interstitial fluid, with their distribution mediated in all animals (but not in all plants).
Potassium may be detected by taste because it triggers three of the five types of taste sensations, according to concentration. Dilute solutions of potassium ion taste sweet (allowing moderate concentrations in milk and juices), while higher concentrations become increasingly bitter/alkaline, and finally also salty to the taste. The combined bitterness and saltiness of high potassium content solutions makes high-dose potassium supplementation by liquid drinks a palatability challenge.
Membrane polarizationPotassium is also important in preventing muscle contraction and the sending of all nerve impulses in animals through action potentials. By nature of their electrostatic and chemical properties, K+ ions are larger than Na+ ions, and ion channels and pumps in cell membranes can distinguish between the two types of ions, actively pumping or passively allowing one of the two ions to pass, while blocking the other.
A shortage of potassium in body fluids may cause a potentially fatal condition known as hypokalemia, typically resulting from diarrhea, increased diuresis and vomiting. Deficiency symptoms include muscle weakness, paralytic ileus, ECG abnormalities, decreased reflex response and in severe cases respiratory paralysis, alkalosis and cardiac arrhythmia.
Filtration and excretionPotassium is an essential mineral micronutrient in human nutrition; it is the major cation (positive ion) inside animal cells, and it is thus important in maintaining fluid and electrolyte balance in the body. Sodium makes up most of the cations of blood plasma at a reference range of about 145 milliequivalents per liter (3.345 grams) and potassium makes up most of the cell fluid cations at about 150 milliequivalents per liter (4.8 grams). Plasma is filtered through the glomerulus of the kidneys in enormous amounts, about 180 liters per day. Thus 602 grams of sodium and 33 grams of potassium are filtered each day. All but the 1-10 grams of sodium and the 1-4 grams of potassium likely to be in the diet must be reabsorbed. Sodium must be reabsorbed in such a way as to keep the blood volume exactly right and the osmotic pressure correct; potassium must be reabsorbed in such a way as to keep serum concentration as close as possible to 4.8 milliequivalents (about 0.190 grams) per liter. Sodium pumps in the kidneys must always operate to conserve sodium. Potassium must sometimes be conserved also, but as the amount of potassium in the blood plasma is very small and the pool of potassium in the cells is about thirty times as large, the situation is not so critical for potassium. Since potassium is moved passively in counter flow to sodium in response to an apparent Donnan equilibrium, the urine can never sink below the concentration of potassium in serum except sometimes by actively excreting water at the end of the processing. Potassium is secreted twice and reabsorbed three times before the urine reaches the collecting tubules. At that point, it usually has about the same potassium concentration as plasma. If potassium were removed from the diet, there would remain a minimum obligatory kidney excretion of about 200 mg per day when the serum declines to 3.0-3.5 milliequivalents per liter in about one week, and can never be cut off completely. Because it cannot be cut off completely, death will result when the whole body potassium declines to the vicinity of one-half full capacity. At the end of the processing, potassium is secreted one more time if the serum levels are too high.
Potassium in the diet and by supplement
Adequate intakeA potassium intake sufficient to support life can generally be guaranteed by eating a variety of foods, especially plant foods. Clear cases of potassium deficiency (as defined by symptoms, signs and a below-normal blood level of the element) are rare in healthy individuals eating a balanced diet. Foods with high sources of potassium include orange juice, potatoes, bananas, avocados, tomatoes, broccoli, soybeans, brown rice, garlic and apricots, although it is also common in most fruits, vegetables and meats.
Optimal intakeEpidemiological studies and studies in animals subject to hypertension indicate that diets high in potassium can reduce the risk of hypertension and possibly stroke (by a mechanism independent of blood pressure), and a potassium deficiency combined with an inadequate thiamine intake has produced heart disease in rats. With these findings, the question of what is the intake of potassium consistent with optimal health, is debated. For example, the 2004 guidelines of the Institute of Medicine specify a DRI of 4,000 mg of potassium (100 mEq), though most Americans consume only half that amount per day, which would make them formally deficient as regards this particular recommendation. Similarly, in the European Union, particularly in Germany and Italy, insufficient potassium intake is somewhat common.
Medical supplementation and diseaseSupplements of potassium in medicine are most widely used in conjunction with loop diuretics and thiazides, classes of diuretics which rid the body of sodium and water, but have the side effect of also causing potassium loss in urine. A variety of medical and non-medical supplements are available. Potassium salts such as potassium chloride may be dissolved in water, but the salty/bitter taste of high concentrations of potassium ion make palatable high concentration liquid supplements difficult to formulate. Typical medical supplemental doses range from 10 milliequivalents (400 mg, about equal to a cup of milk or 6 oz. of orange juice) to 20 milliequivalents (800 mg) per dose. Potassium salts are also available in tablets or capsules, which for therapeutic purposes are formulated to allow potassium to leach slowly out of a matrix, as very high concentrations of potassium ion (which might occur next to a solid tablet of potassium chloride) can kill tissue, and cause injury to the gastric or intestinal mucosa. For this reason, non-prescription supplement potassium pills are limited by law in the U.S. to only 99 mg of potassium.
Individuals suffering from kidney diseases may suffer adverse health effects from consuming large quantities of dietary potassium. End stage renal failure patients undergoing therapy by renal dialysis must observe strict dietary limits on potassium intake, as the kidneys control potassium excretion, and buildup of blood concentrations of potassium (hyperkalemia) may trigger fatal cardiac arrhythmia.
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