Hirai Hiroyuki, Kanno Makoto, Watanabe Tsuyoshi, Satoh Hiroaki
Department of Nephrology, Hypertension, Diabetology, Endocrinology and Metabolism, Fukushima Medical University, Fukushima, Fukushima 960-1295, Japan.
Department of Internal Medicine, Shirakawa Kosei General Hospital, Shirakawa, Fukushima 961-0005, Japan.
Exp Ther Med. 2017 Aug;14(2):1235-1240. doi: 10.3892/etm.2017.4588. Epub 2017 Jun 13.
The present study reported a case of autosomal dominant polycystic kidney disease complicated with primary aldosteronism in a 49-year-old woman. The patient was referred for refractory hypertension. Laboratory examinations revealed low potassium and renin levels. Computed tomography indicated a right adrenal tumor and multiple renal cysts. Adrenal vein sampling revealed a high aldosterone level on the side of the tumor. The patient was diagnosed with autosomal dominant polycystic kidney disease complicated by primary aldosteronism and adrenalectomy was performed. Over the following 7 months, the estimated glomerular filtration rate decreased from 76 to 48 ml/min/1.73 m, which was attributed to glomerular hyperfiltration correction induced by hyperaldosteronism remission, indicating kidney dysfunction. Clinicians must therefore monitor for the unmasking of kidney dysfunction following adrenalectomy in such cases.
本研究报告了一例49岁女性常染色体显性多囊肾病合并原发性醛固酮增多症的病例。该患者因难治性高血压前来就诊。实验室检查显示低钾和肾素水平降低。计算机断层扫描显示右侧肾上腺肿瘤和多个肾囊肿。肾上腺静脉采血显示肿瘤侧醛固酮水平升高。该患者被诊断为常染色体显性多囊肾病合并原发性醛固酮增多症，并接受了肾上腺切除术。在接下来的7个月里，估计肾小球滤过率从76降至48 ml/min/1.73 m²，这归因于醛固酮增多症缓解引起的肾小球高滤过纠正，提示肾功能不全。因此，临床医生在这类病例中进行肾上腺切除术后必须监测肾功能不全的暴露情况。
