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KMID : 0359920140330040229
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Korean Journal of Nephrology
2014 Volume.33 No. 4 p.229 ~ p.233
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A case of primary aldosteronism combined with acquired nephrogenic diabetes insipidus
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Kim Ki-Tae
Lee Jae-Hyoung
Kim Sun-Chul
Cha Dae-Ryong
Kang Young-Sun
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Abstract
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Aldosterone-producing adrenal adenoma can induce various clinical manifestations as a result of chronic exposure to aldosterone.We report a rare case of a 37-year-old man who complained of general weakness and polyuria. He was diagnosed with aldosterone-producing adrenal adenoma and nephrogenic diabetes insipidus. Aldosterone enhances the secretion of potassium in the collecting duct, which can lead to hypokalemia. By contrast, nephrogenic diabetes insipidus, which manifests as polyuria and polydipsia, can occur in several clinical conditions such as acquired tubular disease and those attributed to toxins and congenital causes. Among them, hypokalemia can also damage tubular structures in response to vasopressin. The patient’s urine output was 43 L/d and was diluted. Owing to the ineffectiveness of vasopressin, we eventually made a diagnosis of nephrogenic diabetes insipidus. Laparoscopic adrenalectomy and intraoperative kidney biopsy were subsequently performed. The pathologic finding of kidney biopsy revealed a decrease in aquaporin-2 on immunohistochemical stain.
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KEYWORD
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Aquaporin, Diabetes insipidus, Hyperaldosteronism, Hypokalemia
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