Effect of potassium chloride supplements on upper gastrointestinal mucosa.
Eight controlled 1- or 2-wk experiments involving 225 healthy male subjects and one study of 18 patients with hypertension, nine of whom were long-term users of a wax-matrix potassium chloride preparation, were conducted to evaluate the upper gastrointestinal safety of oral KCl supplements. All subjects in the short-term studies had normal upper gastrointestinal tracts. Subjects were examined again after at least 7 days of treatment with one of three commonly prescribed wax-matrix KCl tablets, KCl liquid, microencapsulated KCl, a potassium- sparer , or placebo. Some received an anticholinergic drug with treatment to induce delayed gastric motility. Diet and compliance to treatment regimens were controlled. Results indicate that upper mucosal injury, particularly erosions (43%) and ulcerations (11%), were more frequent after wax-matrix tablets. These changes occurred much less frequently after liquid KCl (0%), microencapsulated KCl (10.5% erosions, 1.2% ulcers), and the potassium-sparing drug (0%). More serious and more frequent lesions were associated with slowed motility. No occult bleeding was noted. Symptomatic complaints did not correlate with endoscopic findings. In the long-term study, patients with hypertension were examined endoscopically after 19 to 23 mo on KCl and again after 1 wk. Six of nine of the patients with hypertension treated for nearly 2 yr with a wax-matrix KCl supplement had significant lesions. One had developed ulceration after 7 days.(ABSTRACT TRUNCATED AT 250 WORDS)
D003692:Delayed-Action Preparations; D004724:Endoscopy; D005753:Gastric Mucosa / Q000187:drug effects* / Q000473:pathology; D006024:Glycopyrrolate / Q000009:adverse effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D007413:Intestinal Mucosa / Q000187:drug effects* / Q000473:pathology; D008297:Male; D011189:Potassium Chloride / Q000008:administration & dosage / Q000009:adverse effects*; D011897:Random Allocation; D013276:Stomach Ulcer / Q000139:chemically induced; D013997:Time Factors
D003692:Delayed-Action Preparations; D011189:Potassium Chloride; D006024:Glycopyrrolate