A Case of Primary Aldosteronism after Renal Transplantation

Korean Journal of Nephrology 2009;28(1):77-81.

Joon Chang Song, M.D., Hyeon Seok Hwang, M.D., Bok Jin Hyoung, M.D., Yeon Joo Jeon, M.D., So Young Lee, M.D., Se Na Chang, M.D. Hye Eun Yoon, M.D., Bum Soon Choi, M.D., Yong Soo Kim, M.D. and Chul Woo Yang, M.D.

Division of Nephrology, Department of Internal Medicine, College of Medicine The Catholic University of Korea, Seoul, Korea

증례 : 신이식 후 발현된 일차 알도스테론증 1예

송준창, 황현석, 형복진, 이소영, 전연주, 장세나, 윤혜은, 최범순, 김용수, 양철우

가톨릭대학교 의과대학 내과학교실 신장내과

Abstract

After renal transplantation, we are more likely to encounter hyperkalemia rather than hypokalemia. We report a case of kidney transplantation recipient with hypokalemia and hypertension secondary to primary aldosteronism. A 48 year-old woman was presented with fatigue and weight loss that had lasted for 3 months. She was diagnosed as autosomal dominant polycystic kidney disease that ultimately progressed to end-stage renal disease. She was operated for renal transplantation before 6 months. She had hypokalemia and hypertension at that time. The ratio of plasma aldosterone over plasma renin activity was 851.7. The computed tomography (CT) revealed 2.4×1.7 cm sized adrenal mass on the right side. The pre-transplantation CT also showed that there had been adrenal mass in the same location even before the transplantation. Right adrenalectomy was performed. After she got discharged, she was again presented with nausea and vomiting. She developed hyperkalemia and was diagnosed as hyporeninemic hypoaldosteronism. She was prescribed with fludrocortisones and recovered from the disease, and resumed the state of normokalemia and normotension.

Key Words: Primary aldosteronism, Renal transplantation, Hypokalemia