Department of Internal Medicine, Erasmus Medical Center, Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands.
Nat Rev Nephrol. 2011 Jan;7(1):55-60. doi: 10.1038/nrneph.2010.158. Epub 2010 Nov 23.
A 57-year-old woman was referred to a nephrology clinic because of chronic hypokalemia. She had a history of polycystic kidney disease, resistant hypertension, atrial fibrillation, type 2 diabetes, stroke, and end-stage renal disease, and had received a kidney transplant from a deceased donor at the age of 48 years. At presentation, the patient described symptoms of chronic fatigue and muscle aches, but she did not report pareses. Her medications included four antihypertensive agents, glucose-lowering drugs, immunosuppressants, digoxin, a coumarin derivative, and potassium chloride.
Full history, physical examination, laboratory testing of blood and urine, including aldosterone-torenin ratio, and a saline infusion test.
Primary aldosteronism.
Treatment with spironolactone resulted in prompt control of hypertension and hypokalemia, allowing discontinuation of potassium chloride and reduction in antihypertensive medication.
一名 57 岁女性因慢性低钾血症被转诊至肾病科。她有多囊肾病、耐药性高血压、心房颤动、2 型糖尿病、中风和终末期肾病病史，并于 48 岁时接受了一位已故供者的肾脏移植。就诊时，患者描述了慢性疲劳和肌肉疼痛的症状，但她没有报告瘫痪。她的药物包括四种降压药、降糖药、免疫抑制剂、地高辛、香豆素衍生物和氯化钾。
详细病史、体格检查、血液和尿液的实验室检查，包括醛固酮-肾素比值和盐水输注试验。
原发性醛固酮增多症。
螺内酯治疗迅速控制了高血压和低钾血症，允许停用氯化钾并减少降压药物。
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