title: A case of primary aldosteronism combined with acquired nephrogenic diabetes insipidus.
abstract: Aldosterone-producing adrenal adenoma can induce various clinical manifestations as a result of chronic exposure to aldosterone. We report a rare case of a 37-year-old man who complained of general weakness and polyuria. He was diagnosed with aldosterone-producing adrenal adenoma and nephrogenic diabetes insipidus. Aldosterone enhances the secretion of potassium in the collecting duct, which can lead to hypokalemia. By contrast, nephrogenic diabetes insipidus, which manifests as polyuria and polydipsia, can occur in several clinical conditions such as acquired tubular disease and those attributed to toxins and congenital causes. Among them, hypokalemia can also damage tubular structures in response to vasopressin. The patient's urine output was >3 L/d and was diluted. Owing to the ineffectiveness of vasopressin, we eventually made a diagnosis of nephrogenic diabetes insipidus. Laparoscopic adrenalectomy and intraoperative kidney biopsy were subsequently performed. The pathologic finding of kidney biopsy revealed a decrease in aquaporin-2 on immunohistochemical stain.
authors.affiliation: Department of Nephrology, Korea University Medical College, Ansan Hospital, Ansan, Korea.
authors.forename: Kitae
authors.initials: K
authors.lastname: Kim
authors.affiliation: Department of Nephrology, Korea University Medical College, Ansan Hospital, Ansan, Korea.
authors.forename: Jae Hyoung
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Nephrology, Korea University Medical College, Ansan Hospital, Ansan, Korea.
authors.forename: Sun Chul
authors.initials: SC
authors.lastname: Kim
authors.affiliation: Department of Nephrology, Korea University Medical College, Ansan Hospital, Ansan, Korea.
authors.forename: Dae Ryong
authors.initials: DR
authors.lastname: Cha
authors.affiliation: Department of Nephrology, Korea University Medical College, Ansan Hospital, Ansan, Korea.
authors.forename: Young Sun
authors.initials: YS
authors.lastname: Kang
keywords: Aquaporin; Diabetes insipidus; Hyperaldosteronism; Hypokalemia