FREDERIC C. BARTTER, M.D.; EDWARD G. BIGLIERI, M.D.
Dr. Frederic C. Bartter: The diagnosis of primary aldosteronism is suggested by the findings of hypertension, hypokalemia and alkalosis.
The chemical abnormalities result from the continuous autonomous overproduction of aldosterone, resulting in excessive excretion of hydrogen and potassium ions, presumably exchanged for sodium ions by renal tubular cells. As potassium depletion ensues, (1) urinary ammonia excretion increases, and the urine may become alkaline despite continued excessive hydrogen excretion, (2) the ability to produce a concentrated urine, even with exogenous pitressin, may be lost, with resultant relative water loss and hypernatremia, (3) further renal damage may result in nitrogen retention and
BARTTER FC, BIGLIERI EG. PRIMARY ALDOSTERONISM: CLINICAL STAFF CONFERENCE AT THE NATIONAL INSTITUTES OF HEALTH1. Ann Intern Med. ;48:647–654. doi: 10.7326/0003-4819-48-3-647
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Published: Ann Intern Med. 1958;48(3):647-654.
DOI: 10.7326/0003-4819-48-3-647