J Korean Endocr Soc.  2009 Sep;24(3):201-205. 10.3803/jkes.2009.24.3.201.

A Case of Persistent Hyperkalemia After Unilateral Adrenalectomy for Aldosterone-Producing Adenoma

• Yang MJ
• Han SJ
• Lee MS
• Kim EK
• Kim HJ
• Kim DJ
• Chung YS
• Lee TH
• Kim JH
• Lee KW

• KMID: 2178183
• DOI: http://doi.org/10.3803/jkes.2009.24.3.201

Abstract

Primary aldosteronism is a syndrome characterized by various clinical features that are due to excessive autonomous aldosterone secretion not sustained by the activation of the renin-angiotensin system. Aldosterone-producing adrenal adenoma is found in approximately 35% of the patients who suffer with primary aldosteronism. Laparoscopic adrenalectomy is the standard treatment for aldosterone-producing adrenal adenoma, and the result of this operation is normalization of the serum potassium and plasma aldosterone concentrations, as well as correcting the plasma renin activity in most cases. However, it is known that some of the patients with aldosterone-producing adrenal adenoma show transient hyperkalemia postoperatively due to the reversible suppression of the renin-aldosterone axis. We recently experienced the case of a 54-year-old woman with an aldosterone-producing adrenal adenoma, and she presented with severe hyperkalemia after unilateral adrenalectomy. Compared with the previously reported cases that showed transient suppression of the rennin-aldosterone axis for less than 7 months, our patient revealed a prolonged episode of hyperkalemia for 8 months postoperatively, and this required continuous mineralocorticoid replacement.

Keyword

aldosterone-producing adenoma; hyporeninemic hypoaldosteronism; postoperative hyperkalemia

MeSH Terms

Adenoma
Adrenalectomy
Aldosterone
Axis, Cervical Vertebra
Female
Humans
Hyperaldosteronism
Hyperkalemia
Hypoaldosteronism
Middle Aged
Plasma
Potassium
Renin
Renin-Angiotensin System
Aldosterone
Potassium
Renin