BARBARA J. FLEMING, M.D.; SAUL M. GENUTH, M.D., F.A.C.P.; ANNE B. GOULD, PH.D.; MARIO D. KAMIONKOWSKI, M.D.
A patient with marked chronic hypokalemia (potassium, 1.7 to 2.3 meq/litre) and sodium depletion secondary to laxative abuse and dietary inadequacy was studied with respect to the renin-aldosterone system during sequential potassium and potassium-plus-sodium replacement. Extreme hyperreninemia of 20 Goldblatt units X 10-4 was reduced to 0.9 with potassium replacement alone. Aldosterone excretion (15.8 µg/24 h) was initially low for a sodium-deprived state and high for a potassium-deprived state; it increased with potassium administration, but this rise was opposed by decreases in renin secretion induced by potassium and sodium administration. The results provide clinical confirmation of a dual effect of potassium on aldosterone secretion, with renin as a mediator.
BARBARA J. FLEMING, SAUL M. GENUTH, ANNE B. GOULD, MARIO D. KAMIONKOWSKI. Laxative-Induced Hypokalemia, Sodium Depletion and Hyperreninemia: Effects of Potassium and Sodium Replacement on the Renin-Angiotensin-Aldosterone System. Ann Intern Med. 1975;83:60–62. doi: 10.7326/0003-4819-83-1-60
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Published: Ann Intern Med. 1975;83(1):60-62.
Endocrine and Metabolism, Fluid and Electrolyte Disorders, Nephrology.
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