Electrolyte Blood Press.  2016 Jun;14(1):11-15. 10.5049/EBP.2016.14.1.11.

Hypokalemic Hypertension Leading to a Diagnosis of Autosomal Dominant Polycystic Kidney Disease

• Vutthikraivit W
• Assanatham M
• Sriphrapradang C

• KMID: 2328425
• DOI: http://doi.org/10.5049/EBP.2016.14.1.11

Abstract

Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited renal disease. Hypertension is common and occurs before decline in renal function. However, the coexistence of hypertension and hypokalemia is rare in ADPKD patients. We report on a 32-year-old woman with secondary aldosteronism. Magnetic resonance imaging of the renal arteries revealed multiple cysts of varying sizes in both the kidneys and the liver, compatible with ADPKD. Increased reninangiotensin-aldosterone system activity was secondary to cyst expansion. After initiation of angiotensin II receptor blocker, her blood pressure was controlled without additional requirement of potassium.

Keyword

Angiotensin receptor antagonists; Autosomal dominant polycystic kidney disease; Hyperaldosteronism; Hypertension; Hypokalemia

MeSH Terms

Adult
Angiotensin Receptor Antagonists
Blood Pressure
Diagnosis*
Female
Humans
Hyperaldosteronism
Hypertension*
Hypokalemia
Kidney
Liver
Magnetic Resonance Imaging
Polycystic Kidney, Autosomal Dominant*
Potassium
Receptors, Angiotensin
Renal Artery
Angiotensin Receptor Antagonists
Potassium
Receptors, Angiotensin

Figure

• 

  Fig. 1 Magnetic resonance imaging of the renal artery revealed innumerable cysts, causing diffuse enlargement of both kidneys. The cysts ranged from subcentimeter size to the largest diameter of 5.3 cm. The largest cyst is seen at the upper pole of the right kidney, which had thin septation. Also, there were multiple small hepatic cysts ranging from tiny to 1.1 cm in diameter (not shown). Renal arteries and adrenal glands were normal (not shown).

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