Innovative Journal Journal of Medical Biomedical and Applied Sciences 2277:4939 10 04 Impact of Persistent Hyperglycemia on fractional Excretion of Potassium. 1 Dr Rajesh Kumar Sinha Associate Professor, Department Of Physiology, RIMS, Ranchi Dr Kumar Ashutosh Jr Resident(Physiology) RIMS, Ranchi Journal Article https://doi.org/10.15520/ijmhs.v10i03.282 Abstract Background -Our daily recommended use of potassium is 3.5 gm/day 1. Potassium is a positive electrically charged particle called anions that takes part in carrying the nerve impulses. In healthy person safe level of potassium varies between 3.7 and 5.2 milliequivqnt per liter (mEq/L).8 Till the kidney functions are not compromised physiological level is maintained Even in low or high intake of potassium. Complication of hyperkalemia is slow heart beat and weak pulse but in case of severe hyperkalemia there may be stoppage of cardiac impulse.10 In poorly controlled diabetes mellitus II more breakdown of adipose tissue due to lack of insulin cause more ketone production and ketoacidois. This ketoacidosis along with hyperglycemia tends to pull the potassium out the cell. The combination of shift out of potassium from the cell and diminished potassium excretion by the kidney leads to hyperkalemia in case of Diabetes Mellitus type II. Material and method 111 subjects having age between 30 to 55 both diabetic and non diabetic were selected. 5 ml blood was collected by vein puncture and fasting blood sugar, serum potassium level and HbA1c was estimated in the department of physiology .Fractional excretion of potassium will be calculated by the formula given below. Fractional excretion of potassium was calculated by the formula given below: FEK = ( Urine K/Serum K)/ (Urine Cr /Serum Cr) X 100 11 Result - Serum Creatinine was within normal limit <1mg/dl in Group A and B Where HbA1C range was 5-6.5. Even in Group C HbA1c range 6.6-7.9 serum creatinine was normal. Level of serum creatinine rises to 1.3 in group D where the HbA1C was >8%Mean excretion of potassium in urine was 36 mg/dl and 38mg/dl in HbA1C range between 5-5.6 % and 5.7-6.5 %respectively. in cases where HbA1C was > 8% excretion of potassium in urine was only 39mg/dl though it was increased a little 42mg/dl when HbA1C range was 6.5-7.9% FEK was 8.1 till the HbA1C remains below 6.5% . FEK Gradually decreased to 7.5% in HbA1C range 6.6-6.9% and even more lower 6.8% when HbA1C was > 8%. Discussion - In Persistent poor control of blood sugar level kidney fails to handle the potassium excretion and subsequently Serum potassium level begins to rise. kidney tries to maintain the serum potassium level not only by increasing the excretory rate of potassium .when the there was poor glycemic control ,i.e HbA1c was more the 8 % in spite of having more excretion of potassium. Conclusion- High level of potassium observed in case patients of diabetes mellitus. Regular check up of micro albumin in the urine ,Keeping the HB1Ac level below 7 ,by cutting down the intake of potassium in diet, progress of kidney disease in case of Diabetes mellitus can be minimized. 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