Hyporeninemic hypoaldosteronism(HH) has been characterized as combination of hyperkalemia, decreased plasma renin activity( PRA) and aldosterone although blood cortisol level are reserved.
We are reporting 3 cases of HH, of which first case involves 59 year-old male with diabetic nephropathy. who has been on hemodialysis for 6 years. He had lowered PRA and aldosterone in the blood with severe hyperkalemia although blood cortisol level were normal. Therefore, we administered Kalimate´.
Second case involves 28 year-old female with diabetic nephropathy and hypertension. Therefore, she is receiving injection of insulin and antihypertension drugs without hemodialysis yet. She also had decreased PRA and aldosterone with normal cortisol level and increased K in the blood.
Third case involves 39 year-old female, who developed uremia with hydronephrosis after irradiation therapy for ovary cancer. She also had decreased PRA and aldosterone with normal cortisol level in the blood but increased K in the plasma. Therefore, she has been on hemodialysis for one year. We experienced cardiac arrest twice predialysis period this patient. Therefore, fludrocortisone therapy (0.6 mg/day) had good response from this patient.
In summary, we are suggesting that, in patients with hyperkalemia and renal disease, HH syndrome should be thought of.
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