Cuervas-Mons V, Moya Mir M S, Martín Martín F, Barbadillo García de Velasco R, Sánchez Miró I, Martín Jiménez T, Lorenz Pérez P
Med Clin (Barc). 1980 Nov 10;75(8):342-5.
A 75 year-old male presented with hyperkalemia unexplained by a moderate renal insufficiency, low basal levels of aldosterone and renin with a subnormal response to walking and saline depletion, and normal glucocorticoid function. The hyperkalemia was corrected by fluorocortisone administration. The concept of hypoaldosteronism is reviewed, defining it as an isolated aldosterone deficiency and thus excluding the combined deficiency of cortisol and aldosterone and the suprarenal enzyme deficits that simultaneously involve mineralocorticoid and glucocorticoid synthesis. Depending on the presence or absence of alterations of the renin-angiotensin axis, this infrequent syndrome can be pathophysiologically classified as low, normal or high renin hypoaldosteronism. The characteristic features of each type are described, and emphasis is made on the need for a high index of suspicion when unexplained hyperkalemia is present in order to perform the appropriate tests to confirm or rule out hypoaldosteronism.
一名75岁男性出现高钾血症，中度肾功能不全无法解释该症状，醛固酮和肾素基础水平较低，对行走和盐水消耗反应异常，糖皮质激素功能正常。服用氟氢可的松后高钾血症得到纠正。本文回顾了醛固酮减少症的概念，将其定义为孤立的醛固酮缺乏，从而排除了皮质醇和醛固酮联合缺乏以及同时涉及盐皮质激素和糖皮质激素合成的肾上腺酶缺乏。根据肾素-血管紧张素轴是否存在改变，这种罕见综合征在病理生理学上可分为低肾素、正常肾素或高肾素醛固酮减少症。描述了每种类型的特征，并强调当出现无法解释的高钾血症时，需要高度怀疑，以便进行适当的检查来确认或排除醛固酮减少症。
