Persistent hyperkalaemia in elderly patients caused by
hyporeninaemic hypoaldosteronism is relatively common and often
under recognised in the general practice setting.
This article highlights the importance of suspecting hyporeninaemic
hypoaldosteronism in any elderly patient with persistent
hyperkalaemia and provides an outline of investigation and
management of the condition.
Elderly patients with persistent hyperkalaemia may have
hyporeninaemic hypoaldosteronism. The diagnosis is made by
calculating the transtubular potassium concentration gradient,
and then measuring the serum aldosterone level. Hyporeninaemic
hypoaldosteronism is managed with a low potassium diet and a low
dose loop or thiazide diuretic.
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