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Nature Reviews Nephrology 2011-Jan

A case of primary aldosteronism revealed after renal transplantation.

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Ewout J Hoorn
Dennis A Hesselink
Marcia M Kho
Joke I Roodnat
Willem Weimar
Jan L van Saase
Anton H van den Meiracker
Robert Zietse

Märksõnad

Abstraktne

BACKGROUND

A 57-year-old woman was referred to a nephrology clinic because of chronic hypokalemia. She had a history of polycystic kidney disease, resistant hypertension, atrial fibrillation, type 2 diabetes, stroke, and end-stage renal disease, and had received a kidney transplant from a deceased donor at the age of 48 years. At presentation, the patient described symptoms of chronic fatigue and muscle aches, but she did not report pareses. Her medications included four antihypertensive agents, glucose-lowering drugs, immunosuppressants, digoxin, a coumarin derivative, and potassium chloride.

METHODS

Full history, physical examination, laboratory testing of blood and urine, including aldosterone-torenin ratio, and a saline infusion test.

METHODS

Primary aldosteronism.

RESULTS

Treatment with spironolactone resulted in prompt control of hypertension and hypokalemia, allowing discontinuation of potassium chloride and reduction in antihypertensive medication.

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