|
| 만성신부전증 신증후군 환자에서 발견된 원발성 알도스테론증 1예 |
| 성재락 , 송경일 , 김정호 , 차미경 , 이은영 , 박민선 , 한동철 , 진소영 , 황승덕 , 문철 , 이희발 |
|
|
| Abstract |
|
Primary aldosteronism is characterized by hyper- tension, hypokalemia, low plasma renin activity (PRA) and elevated plama aldosterone (PA) level. Primary aldosteronism is suspected in patients with hypertension and unexplained hypokalernia. In chronic renal failure(CRF), however, renin-angiotensi naldosterone axis is altered by renal disease per se, antihyppertensive drugs used and volume status. Therefore, it is difficult to diagnose primary aldo- steronism in CRF on the basis of serurn potassium, PRA and PA level. Recently, we experienced a case of primary aldosteronism associated with nephrotic syndrome and CRF. The patient was a 49 years old woman who presented with 10 year old history of high blood pressure and general weakness of one year's duration. Her initial serum creatinine was 7.3mg/dL and serum potassium 2.6mEq/L. PRA was decreased and PA was markedly increased. Persistent hypokalemia urged to evaluate adrenal gland in this case. The round mass was found in left adrenal gland and it was surgically removed. CRF and nephrotic syndrome can alter serum potassium and PRA and there lies the diagnostic dilemma for primary aldosteronsim. It will be well to consider associated primary alodsteronism in a patient with CRF and persistent hypokalemia. |
|
PDF Links
Download Citation
