Renin and Juxlaglomerular Apparatus in a Patient With Primary Aldosteronism Complicated by Chronic Renal Failure

Aldosterone-Producing Adrenocortical Adenoma Complicated by Chronic Renal Failure

“…One report did not describe the postoperative details [21]. However, 2 of 7 patients were treated without adrenalectomy and one demonstrated a stable clinical course [17], although the other patient died of cerebrovascular disease [16]. Our patient was older than these previously reported cases, and it was reported that older patients with aldosterone-producing adrenocortical adenoma were more likely to require postoperative antihypertensive medications [24,25].…”

“…PRA remains in the normal range in 8.8-18.5% of patients with primary aldosteronism [2,11]. In previous reports (table 1), low PRA was noted in only 3 cases [16,19,22]. Iyori et al [16] suggested that renin secretion might be affected by the balance of two factors, i.e.…”

“…However, our patient had chronic renal failure as a risk factor for surgical treat- ment [15]. Only 8 cases of aldosterone-producing adrenocortical adenoma and CRF have been reported previously [16][17][18][19][20][21][22][23]. Table 1 shows the clinical characteristics of 9 patients, including our patient.…”

A Case of Primary Aldosteronism with Chronic Renal Failure Undergoing Hemodialysis Treatment.

“…Therefore, in these patients, the serum potassium level seems to be determined by the balance of the augmentation and the suppression of potassium excretion by excess aldosterone and renal failure, respectively. In fact, in the previously reported patients with primary aldosteronism and renal failure, the serum potassium levels were high in 1 case (Obana et al, 1978), normal in 3 cases (Iyori et al, 1976;Nakada et al, 1984;Naruse et al, 1988), low in 4 cases (Inaba et al, 1977;Shimizu et al, 1978;Obana et al, 1980;Ashino et al, 1988) and unknown in 1 case (Miura et al, 1975). In a cases with hyperpotassemia, whose chronic renal failure rapidly progressed, it might be assumed that potassium accumulation due to renal failure was greater than the aldosterone induced kaliuresis.…”

“…With regard to renin status, in the 9 previously described cases, low renin, which is characteristic in primary aldosteronism, was observed only in one case (Obana et al, 1980), normal renin in 4 cases (Iyori et al, 1976;Inaba et al, 1977;Nakada et al, 1984;Naruse et al, 1988), high renin in 1 case (Obana et al, 1978), and unknown in 3 cases (Miura et al, 1975;Shimizu et al, 1978;Ashino et al, 1988). In general, it is emphasized that hypertensive vascular damage is not so progressive in primary aldosteronism (Laragh, 1973;Freiss et al, 1978).…”