Korean J Med.
1999 Feb;56(2):220-224.
A Case of Transient Hyperkalemia and Hyperaldosteronism secondary to Hydronephrosis
- Affiliations
-
- 1Departments of Internal Medicine, Nowon Eulji Hospital, Eulji Medical College, Seoul, Korea.
Abstract
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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.