Persistent hyperkalaemia.
BACKGROUND
Persistent hyperkalaemia in elderly patients caused by hyporeninaemic hypoaldosteronism is relatively common and often under recognised in the general practice setting.


OBJECTIVE
This article highlights the importance of suspecting hyporeninaemic hypoaldosteronism in any elderly patient with persistent hyperkalaemia and provides an outline of investigation and management of the condition.


CONCLUSIONS
Elderly patients with persistent hyperkalaemia may have hyporeninaemic hypoaldosteronism. The diagnosis is made by calculating the transtubular potassium concentration gradient, and then measuring the serum aldosterone level. Hyporeninaemic hypoaldosteronism is managed with a low potassium diet and a low dose loop or thiazide diuretic.
Xu
Bo
B
Geriatric Evaluation and Management Unit, St Vincent's Hospital, Melbourne, Victoria. greatbear227@hotmail.com
Murray
Michael
M
D000369:Aged, 80 and over; D000450:Aldosterone / Q000097:blood; D005260:Female; D006801:Humans; D006947:Hyperkalemia / Q000097:blood / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy / Q000652:urine; D006994:Hypoaldosteronism / Q000097:blood / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy / Q000652:urine; D011188:Potassium / Q000097:blood / Q000652:urine
D000450:Aldosterone; D011188:Potassium