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

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.

Keyword

Hydronephrosis; Hyperkalemia; Hyperaldosteronism

MeSH Terms

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
Aldosterone
Hydrogen
Potassium
Water
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