Hyporeninemic Hypoaldosteronism 3예

Hyporeninemic hypoaldosteronism(HH) has been characterized as combination of hyperkalemia, decreased plasma renin activity(PRA) and aldo- sterone although blood cortisol level are reserved. We are reporting 3 cases of HH, of which first case involves 59 year-old male with diabetic ne- phropathy, 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 admini- stered Kalimate. Second case involves 28 year-old female with diabetic nephropathy and hypertension. Therefore, she is receiving injection of insuline and antihy- pertension 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 irra- diation 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, fludro- cortisone therapy(Q. 6 mg/day) had good response from this patient. In summary, we are suggesting that, in patients with hyperkalemia and renal disease, HH syn- drome should he thought of.