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      Relation between Plasma Aldosterone Concentration and Renal Handling of Sodium and Potassium, in Particular in Patients with Chronic Renal Failure

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          Abstract

          In normal subjects a relation was found between the log plasma aldosterone concentration (PAC) and the ratio of renal potassium excretion (U<sub>ĸ</sub>) and sodium delivery to the sodium-potassium exchange site (U<sub>Na+ĸ</sub>). This relationship was independent of plasma renin activity (PRA). On these grounds, the U<sub>ĸ</sub>/U<sub>Na+ĸ</sub> ratio disturbance was considered to be a function of the PAC, and this relation was considered to reflect an altered sensitivity of the distal tubule to aldosterone. In several pathological conditions involving the kidney, the relation between the PAC and U<sub>ĸ</sub>/U<sub>Na+ĸ</sub> remained normal while the glomerular filtration rate was within normal limits. Under these conditions, however, the serum potassium concentration had some influence on this relation, in that a low potassium concentration was accompanied by an elevated (though still normal) PAC relative to the U<sub>ĸ</sub>/U<sub>Na+ĸ</sub> ratio. The relation was completely abolished when the effect of endogenous aldosterone was impaired by chronic spironolactone administration in patients with essential hypertension. Analysis to these relations in chronic renal disease made it possible to classify them according to the pathophysiological disturbance in question. We conclude that determination of the U<sub>ĸ</sub>/U<sub>Na+ĸ</sub> ratio and its relation to the PAC, PRA, and serum potassium level is very useful for the analysis of disorders of potassium metabolism.

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          Author and article information

          Journal
          NEF
          Nephron
          10.1159/issn.1660-8151
          Nephron
          S. Karger AG
          1660-8151
          2235-3186
          1984
          1984
          04 December 2008
          : 37
          : 2
          : 94-99
          Affiliations
          Department of Nephrology and Hypertension, University Hospital, Utrecht, The Netherlands
          Article
          183221 Nephron 1984;37:94–99
          10.1159/000183221
          6374484
          © 1984 S. Karger AG, Basel

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          Page count
          Pages: 6
          Categories
          Original Paper

          Cardiovascular Medicine, Nephrology

          Aldosterone, Sodium, Potassium, Renal insufficiency

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