Korean Journal of Medicine  1999;56(2):220-224

A Case of Transient Hyperkalemia and Hyperaldosteronism secondary to Hydronephrosis.

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

Affiliations

+expand

Keywords

Hydronephrosis; Hyperkalemia; Hyperaldosteronism

Country

Republic of Korea

Language

Korean

MeSH

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.