Primary Aldosteronism: Observations on Water and Electrolyte Changes During Partial Immersion

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Abstract
Studies are reported of the effect of posture and immersion on fluid and electrolyte excretion in a 44-yr-old white male with primary aldosteronism. The patient exhibited excessive retention of sodium and water during a 4-hr period of ambulation after a water load of 15 ml/kg, but he excreted sodium and water normally after a second water load while recumbent for 4 hr. The effect of partial immersion of the patient (to the neck in water at 94 F) for 4 hr on electrolyte and aldosterone levels was studied preoperatively and 11 weeks after removal of an adrenalcortical adenoma. Preoperatively he exhibited the following changes during the 4-hr period of immersion: There was little or no change in plasma aldosterone; he excreted 187 mEq of sodium and 31 mEq of potassium in 2130 ml of urine; and the creatinine clearance increased normally. Postoperatively, the patient had a 50% decrease in plasma aldosterone into the normal range during immersion; he excreted 14 mEq of sodium, 17 mEq of potassium in 230 ml of urine in the 4-hr period; and creatinine clearance increased normally.

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