Effect of Alterations of Sodium Intake in Patients with Hyporeninemic Hypoaldosteronism

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Abstract
The effect of changes of Na intake on serum and urinary electrolytes, plasma renin activity (RA) and plasma aldosterone concentration (PA) was studied in 5 hyperkalemic patients with the syndrome of hyporeninemic hypoaldosteronism (SHH). The patients were evaluated during 8 days on a 10 meq Na and 50 meq K diet plus furosemide, followed by 8 days on a 150 meq Na and 50 meq K diet. After Na depletion, both PRA and PA were substantially higher than after a previous 4 day period of simple dietary Na restriction, and an increase in serum K concentration occurred in only 1 subject. Administration of a normal Na intake induced small increases in serum Cl- in all 5 subjects and a decrease in bicarbonate concentration in 1 patient. At least in some patients with SHH, PRA and PA are volume-responsive, and considerable alterations of Na intake have relatively little influence on serum electrolyte concentrations.

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