Nephrol Dial Transplant (2014) 29: 981 doi: 10.1093/ndt/gfu095
Introduction Introduction to ‘Integration of the response to dietary potassium load: a paleolithic perspective’ Eberhard Ritz
© The Author 2014. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.
programmed for the environment prevalent in Paleolithic times. As one example they discuss the handling of L-lactic acid and its role in shifting K+ into the liver. Kamel and co-authors provide arguments that in the emergency situation of hyperkalaemia the administration of both Na+ lactate and a smallish dose of insulin is an effective strategy to lower plasma K+ while the risk of hypoglycemia remains low. This is one of several examples of different pathophysiological situations for which today’s interventions might still be based on mechanisms which were presumably also lifesaving in a paleolithic environment. For several of their proposals the authors call – with much justification – for clinical studies to verify that what physiologists have found in the rat is applicable in humans as well. I hope that reading this overview is rewarding – not only to acquire professional expertise, but also for intellectual enjoyment.
981
Downloaded from http://ndt.oxfordjournals.org/ at University of Michigan on January 5, 2015
In this issue of NDT K.S. Kamel, M. Schreiber and M.L. Halperin propose the hypothesis that some at first sight puzzling mechanisms of renal and hepatic function can be explained by the hypothesis that they were elected for what had been an optimized performance of the kidney and liver in the paleolithic environment. Our ancestors’ diet consisted mainly of fruit and berries which provided rich amounts of sugar, potassium and organic ions, but little sodium and chloride. The authors of this fascinating review propose hypothetical, but very plausible, mechanisms for some puzzling observations concerning how the kidney and liver handle some emergencies (the full version of their paper is available in this month’s issue of NDT). The authors propose that some of these puzzling observations may be explained by the hypothesis that the kidneys of today’s human beings work with a renal and hepatic machinery which in some respects is still
Introduction Introduction to ‘Integration of the response to dietary potassium load: a paleolithic perspective’ Eberhard Ritz
© The Author 2014. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.
programmed for the environment prevalent in Paleolithic times. As one example they discuss the handling of L-lactic acid and its role in shifting K+ into the liver. Kamel and co-authors provide arguments that in the emergency situation of hyperkalaemia the administration of both Na+ lactate and a smallish dose of insulin is an effective strategy to lower plasma K+ while the risk of hypoglycemia remains low. This is one of several examples of different pathophysiological situations for which today’s interventions might still be based on mechanisms which were presumably also lifesaving in a paleolithic environment. For several of their proposals the authors call – with much justification – for clinical studies to verify that what physiologists have found in the rat is applicable in humans as well. I hope that reading this overview is rewarding – not only to acquire professional expertise, but also for intellectual enjoyment.
981
Downloaded from http://ndt.oxfordjournals.org/ at University of Michigan on January 5, 2015
In this issue of NDT K.S. Kamel, M. Schreiber and M.L. Halperin propose the hypothesis that some at first sight puzzling mechanisms of renal and hepatic function can be explained by the hypothesis that they were elected for what had been an optimized performance of the kidney and liver in the paleolithic environment. Our ancestors’ diet consisted mainly of fruit and berries which provided rich amounts of sugar, potassium and organic ions, but little sodium and chloride. The authors of this fascinating review propose hypothetical, but very plausible, mechanisms for some puzzling observations concerning how the kidney and liver handle some emergencies (the full version of their paper is available in this month’s issue of NDT). The authors propose that some of these puzzling observations may be explained by the hypothesis that the kidneys of today’s human beings work with a renal and hepatic machinery which in some respects is still
