Document Detail


Unilateral renal artery stenosis seen initially as severe and symptomatic hypokalemia. Pathophysiologic assessment and effects of surgical revascularization.
MedLine Citation:
PMID:  8442694     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Hypokalemia is an uncommon presentation of renovascular hypertension. Although renal artery stenosis has been associated with hypokalemia secondary to hyperreninemic hyperaldosteronism, few reports have actually evaluated the pathophysiologic changes in such a patient with renovascular hypertension. We studied a patient before and after surgical revascularization who presented with severe hypertension and marked, symptomatic hypokalemia. Before surgery, the patient had excessive urinary potassium secretion, markedly increased secretion of renin after captopril stimulation, and mild secondary hyperaldosteronism. Postoperatively, the patient's blood pressure decreased moderately and the serum and urinary potassium values normalized. After revascularization, plasma renin activity both before and after captopril stimulation and serum aldosterone levels decreased markedly. These findings demonstrate that renovascular hypertension may rarely present with symptomatic hypokalemia secondary to excessive aldosterone secretion. Improvement in the renal ischemic state is accompanied by rapid correction of the metabolic disturbances associated with hyperreninemic hyperaldosteronism.
Authors:
S T Ruby; A Burch; W B White
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Archives of surgery (Chicago, Ill. : 1960)     Volume:  128     ISSN:  0004-0010     ISO Abbreviation:  Arch Surg     Publication Date:  1993 Mar 
Date Detail:
Created Date:  1993-03-29     Completed Date:  1993-03-29     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9716528     Medline TA:  Arch Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  346-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, University of Connecticut School of Medicine, Farmington.
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MeSH Terms
Descriptor/Qualifier:
Aldosterone / blood
Diagnosis, Differential
Humans
Hyperaldosteronism / blood,  physiopathology
Hypertension, Renovascular / diagnosis,  physiopathology,  surgery
Hypokalemia / diagnosis*,  physiopathology
Male
Middle Aged
Potassium / blood,  urine
Renal Artery / surgery
Renal Artery Obstruction / diagnosis*,  physiopathology,  surgery
Renin / blood
Splenic Artery / surgery
Chemical
Reg. No./Substance:
52-39-1/Aldosterone; 7440-09-7/Potassium; EC 3.4.23.15/Renin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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