Bello Carlos Henrique Pires Ratto Tavares, Duarte João Sequeira, Vasconcelos Carlos
Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal.
J Bras Nefrol. 2017 Oct-Dec;39(4):481-485. doi: 10.5935/0101-2800.20170086.
Hyporeninemic hypoaldosteronism, despite being common, remains an underdiagnosed entity that is more prevalent in patients with diabetes mellitus. It presents with asymptomatic hyperkalemia along with hyperchloraemic metabolic acidosis without significant renal function impairment. The underlying pathophysiological mechanism is not fully understood, but it is postulated that either aldosterone deficiency (hyporeninemic hypoaldosteronism) and/or target organ aldosterone resistance (pseudohypoaldosteronism) may be responsible. Diagnosis is based on laboratory parameters. Treatment strategy varies according to the underlying pathophysiological mechanism and etiology and aims to normalize serum potassium. Two clínical cases are reported and the relevant literature is revisited.
低肾素性低醛固酮血症尽管常见，但仍是一种诊断不足的疾病，在糖尿病患者中更为普遍。它表现为无症状高钾血症以及高氯性代谢性酸中毒，且无明显肾功能损害。其潜在的病理生理机制尚未完全明确，但据推测，醛固酮缺乏（低肾素性低醛固酮血症）和/或靶器官醛固酮抵抗（假性低醛固酮血症）可能是病因。诊断基于实验室指标。治疗策略根据潜在的病理生理机制和病因而异，目标是使血清钾正常化。本文报告了两例临床病例并回顾了相关文献。
