Nonazotemic hyperkalemia with renal and extrarenal defects in potassium transport: Association with high levels of digoxin-like immunoreactive factor

P. Szylman, B. Wolach, J. Winaver, R. Panett, P. Cohen, L. Shenkman, O. S. Better

Research output: Contribution to journalArticlepeer-review

Abstract

We report a hypertensive patient with nonazotemic hyperkalemia caused by a combined disturbance in both the internal and external balance of potassium. During a follow-up of 30 months, exacerbations of hyperkalemia were observed, interposed with a return to the previous baseline. Two brief normokalemic periods were recorded. Blood pressure tended to be higher during hyperkalemic peaks. The following findings were detected: (1) hyperchloremic hyperkalemic acidosis with normal glomerular filtration rate, adequately elevated plasma aldosterone levels, and normovolemia; (2) a tubular defect in potassium excretion, refractory to intravenous sodium sulfate (nonreabsorbable anion) and mineralocorticoids; (3) impaired tissue uptake of potassium under insulin administration; (4) exaggerated hyperkalemia following β-adrenergic blockade and blunted hypokalemic response to a β-agonist; and (5) a defect in Na/K transport in erythrocytes detected in vitro, coexistent with an elevated level of free digoxin-like immunoreactive factor in serum. These results suggest that our patient had a generalized abnormality in potassium transport.

Original languageEnglish
Pages (from-to)315-326
Number of pages12
JournalJournal of Laboratory and Clinical Medicine
Volume116
Issue number3
StatePublished - 1990
Externally publishedYes

Fingerprint

Dive into the research topics of 'Nonazotemic hyperkalemia with renal and extrarenal defects in potassium transport: Association with high levels of digoxin-like immunoreactive factor'. Together they form a unique fingerprint.

Cite this