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January 20, 1969

Potassium Excretion and Atavistic Physiology

Author Affiliations

Evansville, Ind

JAMA. 1969;207(3):561. doi:10.1001/jama.1969.03150160073024

To the Editor:—  The comments of Clifton K. Meador, MD, (206:895, 1968) concerning my editorial, "An Example of Atavistic Physiology?" (204:392, 1968), deserve a reply.Dr. Meador states that the kidney conserves sodium and wastes potassium "only when the intake of the ions is brought virtually to zero." Actually, the body conserves sodium on a diet containing as much as 22 mEq (500 mg), and potassium excretion appears to be obligatory in urine, sweat, and stools even when a deficit is present.Dr. Meador further states, "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.' " My basis for the conclusion is considerably broader than mere extrapolation of experimental results:Electrolyte disturbances, even frank disease, have been attributed to the body's propensity to conserve sodium when it is not needed. Thus, sodium