J Korean Diabetes Assoc.  1998 Dec;22(4):568-573.

A Case of Diabetic Hyporeninemic Hypoaldosteronism Associated with Muscular Symptoms Due to Hyperkalemia

• Oh JY
• Sung YA
• Lee SW
• Sim J

Abstract

Diabetic hyporeninemic hypoaldosteronism is clinically defined syndrome which is characterized by hyperkalemic hyperchloremic metabolic acidosis in patients with diabetic autonomic neuropathy and nephropathy. The major cause of hyporeninemia in diabetes mellitus is the impairement of activation from glycated prorenin to renin. Hyperkalemia is major disorder of this syndrome which is almostly chroniclly developed but acutely developed in case of diabetic patients because of hyperglycemia and hyperkalemic symptoms are usually absent or mild. We experienced a case of diabetic hyporeninemic hypoaldosteronis complicated with acute severe hyperkalemia, myalgia and muscle weakness. The patient complained severe pain and muscle weakness of posterior neck and both lower extremities, serum potassium concentration was 8.5 mEq/L, serum muscle enzymes were very high and electrocardio gram showed ventricular premature beat and generalized T wave inversion. Plasma renin activity and aldosterone concen trations were below normal limits and not stimulated by furosemide administration. After the conservative management of hyperkalemia and g]ycemic control with insulin, serum potassium leve1 and muscle enzymes were normalized.

Keyword

Hyperkalemia; Muscular Symptoms; Hyporeninemic hypoaldosteronism; Diabetes mellitus

MeSH Terms

Acidosis
Aldosterone
Cardiac Complexes, Premature
Diabetes Mellitus
Diabetic Neuropathies
Furosemide
Humans
Hyperglycemia
Hyperkalemia*
Hypoaldosteronism*
Insulin
Lower Extremity
Muscle Weakness
Myalgia
Neck
Plasma
Potassium
Renin
Aldosterone
Furosemide
Insulin
Potassium
Renin