Treating proteinuria in a diabetic patient despite hyperkalaemia due to hyporeninaemic hypoaldosteronism.
Diabetes mellitus is a common cause of hyporeninaemic hypoaldosteronism that might result in significant hyperkalaemia. We describe a patient with diabetic nephropathy and proteinuria who developed a remarkable hyperkalaemia on treatment with an angiotensin-receptor blocker. The management of hyperkalaemia and the pathophysiological background of hyporeninaemic hypoaldosteronism are discussed.
van Nieuwkoop
C
C
Department of General Internal Medicine, Leiden University Medical Centre, PO Box 9600, 2300 RC Leiden, the Netherlands. c.van_nieuwkoop@lumc.nl
Ijpelaar
D H T
DH
Bolk
J H
JH
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D003928:Diabetic Nephropathies / Q000188:drug therapy*; D006801:Humans; D006852:Hydrochlorothiazide / Q000627:therapeutic use*; D006947:Hyperkalemia / Q000209:etiology*; D006994:Hypoaldosteronism / Q000150:complications*; D008875:Middle Aged; D011507:Proteinuria / Q000188:drug therapy* / Q000628:therapy; D013577:Syndrome
D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D006852:Hydrochlorothiazide