Journal of Research in Medical Sciences

CASE REPORT
Year
: 2020  |  Volume : 25  |  Issue : 1  |  Page : 17-

Persistent severe hyperkalemia following surgical treatment of aldosterone-producing adenoma


Cristina Preda1, Laura Claudia Teodoriu2, Sarolta Placinta3, Alexandru Grigorovici4, Stefana Bilha2, Christina M Ungureanu1 
1 Department of Endocrinology, University of Medicine and Pharmacy “Grigore T. Popa”; Department of Endocrinology, Emergency University Hospital “Sf. Spiridon,” Iaşi, Romania
2 Department of Endocrinology, University of Medicine and Pharmacy “Grigore T. Popa”, Iaşi, Romania
3 Department of Endocrinology, Private Medical Practice, Bacău, Romania
4 Department of Endocrinology, University of Medicine and Pharmacy “Grigore T. Popa”; Department of General Surgery, Emergency University Hospital “Sf. Spiridon,” Iaşi, Romania

Correspondence Address:
Dr. Laura Claudia Teodoriu
Department of Endocrinology, Emergency University Hospital “Sf. Spiridon,” Bd. Independentei No. 1, Iasi 700111
Romania

Primary aldosteronism is one of the most common causes of secondary hypertension. This condition is characterized by autonomous hypersecretion of aldosterone which produces sodium retention and potassium excretion, resulting in high blood pressure and potential hypokalemia. Transient postoperative hyporeninemic hypoaldosteronism with an increased risk of hyperkalemia may occur in some patients. We report the case of a 63-year-old patient with persistent hypokalemia, periodic paralysis, and refractory hypertension who was diagnosed with primary hyperaldosteronism due to elevated aldosterone, undetectable plasmatic renin concentration, and the presence of a left adrenal mass. One month after the surgery, the patient was admitted with signs of severe hyperkalemia (8 mmol/L) and worsened renal function, thus requiring hemodialysis. Fluid resuscitation, loop diuretic, and sodium bicarbonate treatment decreased his potassium. Zona glomerulosa insufficiency was confirmed by hormonal tests which exposed low aldosterone–renin axis. The fludrocortisone treatment was initiated and maintained, with consequent potassium and creatinine stabilization. Old age, long duration of hypertension, impaired renal function, severe hypokalemia before surgery, and large size of the aldosterone-producing adenoma are important risk factors for serious potassium imbalance after removal of the adenoma. We have to consider monitoring the patients after surgery for primary hyperaldosteronism in order to prevent severe hyperkalemia; therefore, postoperative immediate follow-up (arterial pressure, potassium, and renal function) is mandatory.


How to cite this article:
Preda C, Teodoriu LC, Placinta S, Grigorovici A, Bilha S, Ungureanu CM. Persistent severe hyperkalemia following surgical treatment of aldosterone-producing adenoma.J Res Med Sci 2020;25:17-17


How to cite this URL:
Preda C, Teodoriu LC, Placinta S, Grigorovici A, Bilha S, Ungureanu CM. Persistent severe hyperkalemia following surgical treatment of aldosterone-producing adenoma. J Res Med Sci [serial online] 2020 [cited 2020 Oct 20 ];25:17-17
Available from: https://www.jmsjournal.net/article.asp?issn=1735-1995;year=2020;volume=25;issue=1;spage=17;epage=17;aulast=Preda;type=0