Shemer J, Royburt M, Cabili S, Iaina A, Pras M, Eliahou H
Department of Internal Medicine, Sheba Medical Center, Tel-Hashomer, Israel.
Ren Fail. 1992;14(4):555-62. doi: 10.3109/08860229209047665.
The renin-aldosterone system and plasma insulin were studied in 19 patients with familial Mediterranean fever (FMF). Their relationships to serum potassium level at rest and before and after oral glucose loading are described. An interesting finding is the occurrence of hyperkalemia in the absence of oliguria, in the advanced stages of renal failure. No differences were found in the activity of the renin-angiotensin-aldosterone system to explain these variations in serum potassium found in some of the patients. The response of the renin-aldosterone system to glucose loading showed no abnormality, and the regular relationship between serum potassium, plasma renin activity (PRA), aldosterone, insulin, and plasma pH is maintained. Levels of insulin, potassium, and bicarbonate in serum or plasma pH were found similar in FMF patients with normal renal function with and without proteinuria. Further decrease in renal function due to the progression of the underlying disease is manifested by an increase in FENa+ and FEK+ and a hyperchloremic metabolic acidosis, as is the case in other patients with chronic renal failure.
对19例家族性地中海热（FMF）患者的肾素-血管紧张素-醛固酮系统和血浆胰岛素进行了研究。描述了它们与静息时以及口服葡萄糖负荷前后血清钾水平的关系。一个有趣的发现是，在肾衰竭晚期无少尿的情况下出现了高钾血症。在肾素-血管紧张素-醛固酮系统的活性方面未发现差异，无法解释部分患者血清钾的这些变化。肾素-血管紧张素-醛固酮系统对葡萄糖负荷的反应未显示异常，血清钾、血浆肾素活性（PRA）、醛固酮、胰岛素和血浆pH之间的正常关系得以维持。在有或无蛋白尿的肾功能正常的FMF患者中，发现血清或血浆pH中的胰岛素、钾和碳酸氢盐水平相似。由于基础疾病进展导致的肾功能进一步下降表现为FENa+和FEK+升高以及高氯性代谢性酸中毒，其他慢性肾衰竭患者也是如此。
