Hyporeninemia and hypoaldosteronism in diabetes mellitus

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Abstract
The changes in plasma renin activity (PRA) and plasma aldosterone concentration (PA) in response to postural stimuli were evaluated in 12 patients with stable diabetes mellitus and in 5 volunteers. Seven diabetic patients had hyperkalemia, and several had renal insufficiency and neurological complications. Five diabetics had normal serum K concentration, a mean creatinine clearance within the normal range and few complications. PRA and PA were measured in these patients and in the control subjects, all of whom were receiving a diet containing 10 meq of Na and 50 meq of K while they were in a supine position, after they were tilted to a 90.degree. position, and after upright posture for 2 h. Impaired responsiveness of PRA and PA may occur in patients with complicated and uncomplicated diabetes and may be responsible in part for a relatively high prevalence of hyperkalemia especially in those diabetic patients with reduced renal function.

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