PMID: 3757436Oct 1, 1986Paper

A simple method for definition of incomplete suppression of aldosterone and its association with hypertension and hypokalaemia in man

Clinical Science
W R Adam

Abstract

By defining a model for control of potassium homoeostasis, patients with unexplained hypokalaemia may then be described as fitting or not fitting the model. Fitting the model implies an abnormality of known control mechanisms (e.g. aldosterone); by contrast, not fitting the model suggests other unknown factors responsible for the hypokalaemia and, possibly, hypertension. In the presence of normal acid-base status, potassium excretion (UK+V) is regulated by plasma potassium (PK+), delivery of sodium to the distal tubule and aldosterone secretion. A linear relationship (correlation coefficient of 0.72) was defined by: UK + V/PK+ = 5.1 X log(UAldoV) X log(UNa+ V) + 1.4 based on a 24 h urine collection and plasma sample, in 16 normal subjects, 50 hypertensive normokalaemic subjects and 11 patients with hyperaldosteronism. The relationship was robust and held true for variations in dietary sodium and potassium intake (5-300 and 20-100 mmol/day respectively) and variations in aldosterone excretion produced by enalapril. Patients with abnormal renal potassium wasting due to known extraneous factors (n = 11) all fell outside the 95% confidence limits. Twelve patients with hypertension and hypokalaemia and renal potassium wasting all fi...Continue Reading

Citations

Sep 1, 1989·Clinical and Experimental Pharmacology & Physiology·W R Adam

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