Renal acidosis and renal potassium handling in selective hypoaldosteronism.

摘要: Abstract Selective hypoaldosteronism was demonstrated in a 60 year old black man with moderate renal insufficiency and hyperkalemic, hyperchloremic acidosis. Urine pH appropriately low during acid loading demonstrating that the hydrogen ion gradient generating capability of distal-most nephron intact. In addition to impaired net excretion acidosis, significant bicarbonaturia present when serum bicarbonate concentration normal. Desoxycorticosterone acetate (DOCA) administration improved potassium handling corrected hyperkalemia but not acidosis or bicarbonaturia. It is concluded patient had idiopathic selective hyporeninemia related hypoaldosteronism. The patient's bicarbonaturia, however, did appear be mineralocorticoid deficiency therefore should attributed other factors.