[Clinical case of the month. Renovascular arterial hypertension complicated by diabetes insipidus: report of a case and review of the literature].
Mrs. A, a 62 year old patient with a history of hypertension, polyuria and polydipsia is hospitalized after a malaise. A severe hypokalemia, which is the cause of the polyuria and polydipsia, is discovered. The presence of hypertension and hypokalemia arises suspicion of a primary hyperaldosteronism and the plasma levels of renin and aldosterone are measured. Elevated aldosterone levels are combined with high plasma renin concentrations which permits to rule out primary hyperaldosteronism. Further explorations reveal a subocclusive ostial stenosis of the right renal artery. A treatment by sartan is instaured, which allows arterial pressure control and kalemia normalization. Chronic hypokalemia can be the cause of tubular nephropathy manifested by nephrogenic diabetes insipidus.
Service de Gastro-Entérologie, CH de Jolimont-Lobbes, Belgique. sfeloni@hotmail.com
S
S
Feloni
L
L
Radermacher
C
C
Remy
J
J
Jousten
V
V
Corman
D000959:Antihypertensive Agents / Q000627:therapeutic use; D003919:Diabetes Insipidus / Q000150:complications*; D005260:Female; D006801:Humans; D006978:Hypertension, Renovascular / Q000150:complications* / Q000188:drug therapy / Q000209:etiology; D007008:Hypokalemia / Q000209:etiology; D008875:Middle Aged; D012078:Renal Artery Obstruction / Q000175:diagnosis
D000959:Antihypertensive Agents