Total Body Potassium Depletion and the Need for Preoperative Nutritional Support in Crohnʼs Disease

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Abstract
Significant intracellular potassium depletion was documented in 57 patients with Crohn's disease by measurements of total body potassium, body water compartments, and red cell Na, KATPase units. Total body potassium deficits paralleled the activity of illness, but were not correlated to serum potassium levels. Treatment before surgery to improve individual body potassium content resulted in a reduced surgical mortality and complication rate compared with a retrospective series of 56 patients in whom pretreatment had simply been aimed at normalizing serum albumin and other standard serum parameters. In conclusion, preoperative nutritional support in Crohn's disease is recommended for patients with a total body potassium level less than 70% of normal. If whole body counting for direct measurement of total body potassium is not available, a Crohn's Disease Activity Index above 225 is proposed as the deciding level, and the parenteral administration of a standardized regimen consisting of 150 to 200 mval potassium plus 2500 to 3000 kcal daily for a two-week period is recommended.