Myoclonic encephalopathy caused by bismuth

: In order to study the effect of physical exercise on serum potassium in renal failure, twelve patients currently on chronic dialysis were subjected to physical exercise by means of an ergometric bicycle. The initial serum potassium was 5.2 +/- 0.6 mmol/l and after the performance of 3.304 +/- 1.583 kilopondimeters of total work, serum potassium was not modified: 5.5 +/- 0.6 mmol/l (p = NS). With regard to the parameters that regulate the intra-cellular distribution of serum potassium, physical exercise aggravated metabolic acidosis, decreasing the blood pH: from 7.33 +/- 0.05 to 7.23 +/- 0.08 (p less than 0.01) and plasma bicarbonate: from 19 +/- 3 mmol/l to 14 +/- 4 mmol/l (p less than 0.01); this was accompanied by a significant and percentage-wise similar increase in plasma epinephrine and norepinephrine. Patients with end-stage renal failure can perform moderate physical exercise, since this does not produce significant changes in serum potassium.