A Case of Transient Hyperkalemia and Hyperaldosteronism secondary to Hydronephrosis.
- Author:
Sung Bae LEE
1
;
Jung Ho UHM
;
Keun Man LEE
;
Kil Sang WANG
;
Young Hoon KIM
;
Kyung Ah HAN
;
Kyung Wan MIN
;
Seol Hye HAN
;
Eung Jin KIM
Author Information
1. Departments of Internal Medicine, Nowon Eulji Hospital, Eulji Medical College, Seoul, Korea.
- Publication Type:Case Report
- Keywords:
Hydronephrosis;
Hyperkalemia;
Hyperaldosteronism
- MeSH:
Acidosis;
Adrenal Insufficiency;
Adult;
Aldosterone;
Child;
Cystectomy;
Diabetic Nephropathies;
Diuresis;
Female;
Humans;
Hydrogen;
Hydronephrosis*;
Hyperaldosteronism*;
Hyperkalemia*;
Hypoaldosteronism;
Infant;
Middle Aged;
Nephrons;
Nephrostomy, Percutaneous;
Potassium;
Reference Values;
Urinary Bladder Neoplasms;
Water
- From:Korean Journal of Medicine
1999;56(2):220-224
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Renal tubular dysfunctions have been observed in hydronephrosis, resulting in metabolic acidosis, hyperkalemia and excessive free water diuresis. These findings are occasionally found in infant and children. Batle et al. first reported distal tubular acidosis associated with low potassium excretion resulting from aldosterone resistance in adults with obstructive uropathy. We have experienced a case of transient hyperkalemia and hyperaldosteronism secondary to hydronephrosis in 63-year-old female patient. The causes of hyperkalemia were examined under the impression of secondary adrenal insufficiency due to corticosteroid abuse or hyporeninemic hypoaldosteronism due to diabetic nephropathy. But it proved to be resulted from hyperaldosteronism due to hydronephrosis. The hyperkalemia resulting from hyperaldosteronism is rare in adults. It may result from aldosterone resistance at distal nephron due to obstructive uropathy or the defect of distal nephron in hydrogen and potassium secretion in the distal nephron rather than from aldosterone deficiency. After she underwent percutaneous nephrostomy, serum potassium was maintained within normal range. She performed total cystectomy with ureterocutaneostomy in purpose for treatment of bladder cancer. So we report this case with a review of literature.
