Geophagia. A cause of life-threatening hyperkalemia in patients with chronic renal failure
M. C. Gelfand, A. Zarate and J. H. Knepshield
Geophagia has been associated with life-threatening hyperkalemia in five
patients with chronic renal failure. All five patients were black and had
been born in the southeastern United States. Four had had frequent
hyperkalemia requiring at least one hospitalization, and two had had
hyperkalemia with serum potassium concentration as high as 9.8 mEq/liter,
resulting in cardiac arrest in one and paralysis, disorientation, and
cardiac arrythmia in the other. Since riverbed clay contains as much as 100
mEq of potassium in 100 gm of clay, much of which is exchangeable at acid
pH, the mechanism of geophagia-induced hyperkalemia appears to be the
absorption of potassium released from clay after ingestion. After
discontinuing geophagia, no new hyperkalemic episodes occurred in these
patients.
