Renal unmasking postadrenalectomy: From hypokalemia to hyperkalemia in primary hyperaldosteronism
This case highlights a patient who was evaluated for hypertension, hypokalemia, and metabolic alkalosis. Subsequently, she was diagnosed with an adrenal adenoma and underwent laparoscopic adrenalectomy. Her renal function was normal before the procedure. However, on follow-up, she was found to have...
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Wolters Kluwer Medknow Publications
2025-01-01
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| Series: | Annals of Medical Science and Research |
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| Online Access: | https://journals.lww.com/10.4103/amsr.amsr_23_24 |
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| author | Joel Thomas Mohammed Fahad Khan Rohan Augustine Vishwanath Siddini Hebri Sudarshan Ballal |
| author_facet | Joel Thomas Mohammed Fahad Khan Rohan Augustine Vishwanath Siddini Hebri Sudarshan Ballal |
| author_sort | Joel Thomas |
| collection | DOAJ |
| description | This case highlights a patient who was evaluated for hypertension, hypokalemia, and metabolic alkalosis. Subsequently, she was diagnosed with an adrenal adenoma and underwent laparoscopic adrenalectomy. Her renal function was normal before the procedure. However, on follow-up, she was found to have gradually increasing creatinine levels, along with a shift from hypokalemia to hyperkalemia. Imaging studies also showed the presence of medullary nephrocalcinosis. The shift from hypokalemia to hyperkalemia is due to chronic suppression of the renin–aldosterone axis of the contralateral adrenal gland. Patients with primary hyperaldosteronism experience a state of hyperfiltration, which masks underlying renal dysfunction. The unmasking of renal dysfunction occurs postprocedure and was responsible for the renal issues observed. Chronic hypokalemia leading to tubular interstitial injury or kaliopenic nephropathy was the underlying cause of medullary nephrocalcinosis in this case. This case report highlights the importance of understanding renal dynamics in patients with primary hyperaldosteronism who have undergone adrenalectomy. |
| format | Article |
| id | doaj-art-8238fadd9a00488fadfc7710087ca638 |
| institution | Kabale University |
| issn | 2949-785X 2949-7868 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Annals of Medical Science and Research |
| spelling | doaj-art-8238fadd9a00488fadfc7710087ca6382025-08-20T03:38:49ZengWolters Kluwer Medknow PublicationsAnnals of Medical Science and Research2949-785X2949-78682025-01-0141434610.4103/amsr.amsr_23_24Renal unmasking postadrenalectomy: From hypokalemia to hyperkalemia in primary hyperaldosteronismJoel ThomasMohammed Fahad KhanRohan AugustineVishwanath SiddiniHebri Sudarshan BallalThis case highlights a patient who was evaluated for hypertension, hypokalemia, and metabolic alkalosis. Subsequently, she was diagnosed with an adrenal adenoma and underwent laparoscopic adrenalectomy. Her renal function was normal before the procedure. However, on follow-up, she was found to have gradually increasing creatinine levels, along with a shift from hypokalemia to hyperkalemia. Imaging studies also showed the presence of medullary nephrocalcinosis. The shift from hypokalemia to hyperkalemia is due to chronic suppression of the renin–aldosterone axis of the contralateral adrenal gland. Patients with primary hyperaldosteronism experience a state of hyperfiltration, which masks underlying renal dysfunction. The unmasking of renal dysfunction occurs postprocedure and was responsible for the renal issues observed. Chronic hypokalemia leading to tubular interstitial injury or kaliopenic nephropathy was the underlying cause of medullary nephrocalcinosis in this case. This case report highlights the importance of understanding renal dynamics in patients with primary hyperaldosteronism who have undergone adrenalectomy.https://journals.lww.com/10.4103/amsr.amsr_23_24adrenal adenomaadrenalectomyhyperkalemianephrocalcinosisprimary hyperaldosteronism |
| spellingShingle | Joel Thomas Mohammed Fahad Khan Rohan Augustine Vishwanath Siddini Hebri Sudarshan Ballal Renal unmasking postadrenalectomy: From hypokalemia to hyperkalemia in primary hyperaldosteronism Annals of Medical Science and Research adrenal adenoma adrenalectomy hyperkalemia nephrocalcinosis primary hyperaldosteronism |
| title | Renal unmasking postadrenalectomy: From hypokalemia to hyperkalemia in primary hyperaldosteronism |
| title_full | Renal unmasking postadrenalectomy: From hypokalemia to hyperkalemia in primary hyperaldosteronism |
| title_fullStr | Renal unmasking postadrenalectomy: From hypokalemia to hyperkalemia in primary hyperaldosteronism |
| title_full_unstemmed | Renal unmasking postadrenalectomy: From hypokalemia to hyperkalemia in primary hyperaldosteronism |
| title_short | Renal unmasking postadrenalectomy: From hypokalemia to hyperkalemia in primary hyperaldosteronism |
| title_sort | renal unmasking postadrenalectomy from hypokalemia to hyperkalemia in primary hyperaldosteronism |
| topic | adrenal adenoma adrenalectomy hyperkalemia nephrocalcinosis primary hyperaldosteronism |
| url | https://journals.lww.com/10.4103/amsr.amsr_23_24 |
| work_keys_str_mv | AT joelthomas renalunmaskingpostadrenalectomyfromhypokalemiatohyperkalemiainprimaryhyperaldosteronism AT mohammedfahadkhan renalunmaskingpostadrenalectomyfromhypokalemiatohyperkalemiainprimaryhyperaldosteronism AT rohanaugustine renalunmaskingpostadrenalectomyfromhypokalemiatohyperkalemiainprimaryhyperaldosteronism AT vishwanathsiddini renalunmaskingpostadrenalectomyfromhypokalemiatohyperkalemiainprimaryhyperaldosteronism AT hebrisudarshanballal renalunmaskingpostadrenalectomyfromhypokalemiatohyperkalemiainprimaryhyperaldosteronism |