A Case of Primary Aldosteronism, Nephrotic Syndrome and Chronic Renal Failure: A Diagnostic Dilemma.
- Author:
Jae Rag SUNG
1
;
Kyoung Il SONG
;
Jeong Ho KIM
;
Mi Kyung CHA
;
Eun Young LEE
;
Min Sun PARK
;
Dong Cheol HAN
;
So Young JIN
;
Seung Duk HWANG
;
Chul MOON
;
Hi Bahl LEE
Author Information
1. Department of Internal Medicine, College of Medicine, Soonchunhyang University, Korea.
- Publication Type:Case Report
- Keywords:
Primary Aldosteronism;
Chronic Renal Failure;
Nephrotic Syndrome;
Hypokalemia
- MeSH:
Adrenal Glands;
Aldosterone;
Axis, Cervical Vertebra;
Child;
Creatinine;
Female;
Humans;
Hyperaldosteronism*;
Hypertension;
Hypokalemia;
Kidney Failure, Chronic*;
Middle Aged;
Nephrotic Syndrome*;
Plasma;
Potassium;
Renin
- From:Korean Journal of Nephrology
1997;16(1):162-166
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Primary aldosteronism is characterized by hypertension, hypokalemia, low plasma renin activity (PRA) and elevated plama aldosterone (PA) level. Primary aldosteronism is suspected in patients with hypertension and unexplained hypokalemia. In chronic renal failure(CRF), however, renin-angiotensin-aldosterone axis is altered by renal disease per se, antihyppertensive drugs used and volume status. Therefore, it is difficult to diagnose primary aldosteronism in CRF on the basis of serum potassium, PRA and PA level. Recently, we experienced a case of primary aldosteronism associated with nephrotic syndrome and CRF. The patient was a 49 years old woman who presented with 10 year old history of high blood pressure and general weakness of one year's duration. Her initial serum creatinine was 7.3mg/dL and serum potassium 2.6mEq/L. PRA was decreased and PA was markedly increased. Persistent hypokalemia urged to evaluate adrenal gland in this case. The round mass was found in left adrenal gland and it was surgically removed. CRF and nephrotic syndrome can alter serum potassium and PRA and there lies the diagnostic dilemma for primary aldosteronsim. It will be well to consider associated primary alodsteronism in a patient with CRF and persistent hypokalemia.
