Pathophysiology of the syndrome of hyporeninemic hypoaldosteronism.
Pathophysiology of the syndrome of hyporeninemic hypoaldosteronism.
复制标题
低肾素血症性低醛固酮增多症综合征的病理生理学。
DOI：
10.1016/0026-0495(80)90145-6
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发表时间：
1980
期刊：
影响因子：
--
通讯作者：
H. J. Carroll
中科院分区：
文献类型：
--
作者：
K. Phelps;R. L. Lieberman;M. Oh;H. J. Carroll
T HE SYNDROME of hyporeninemic hypoaldosteronism (SHH)‘-38 has become widely appreciated only during the past decade, although selective aldosterone deficiency was first described in 1957’and the first series of patients manifesting what is now recognized as the associated syndrome was reported in 1964.’The concept that suppressed plasma renin activity (PRA) might be responsible for the hypoaldosteronemia was first supported by measurements of PRA in 1 972.14 The typical patient with SHH is middle-aged to elderly. He usually has chronic renal insufficiency, which is most frequently caused by diabetes but may be due to gout, chronic pyelonephritis, nephrolithiasis, analgesic abuse, cystic diseases, or hypertensive nephrosclerosis. Tubulointerstitial damage appears to be the pathologic feature common to the renal diseases associated with SHH.Although blood pressure may be normal or low in SHH, it is frequently elevated; the calculated mean arterial pressure exceeds 107 mm Hg in the majority of reported cases.“38 The metabolic disturbance that most commonly arouses suspicion of SHH is hyperkalemia, which is usually chronic but may be provoked acutely by hyperglycemia in diabetics. 25, 29 Frequently, hyperchloremic metabolic acidosis and moderateto-severe hyponatremia, are also present. Restriction of sodium intake often provokes or exacerbates hyperkalemia, acidosis, and hyponatremia, while leading at the same time to excessively negative salt balance. 3s’ 9.23-Serum urea nitrogen and creatinine levels tend to vacillate widely in the individual patient.‘2~‘5~‘7~ 24 Plasma renin activity in the resting state is
