Relative hyporeninemic hypoaldosteronism can present with hypotension and persistent hyperkalemia in adults following unilateral nephrectomy and adrenalectomy, and is effectively managed with fludrocortisone.
Fludrocortisone may correct hyperkalemia and hypotension after nephrectomy/adrenalectomy; single case leaves open need for controlled studies.
Introduction: Persistent hyperkalemia in adults can be caused hyporeninemic hypoaldosteronism (HH), which typically occur in diabetic patients with chronic kidney dysfunction and is associated with hypertension and a mild degree of hyperchloremic acidosis. Rarely, HH may occur and be featured by persistent hyperkalemia and renal salt wasting.
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Palacio et al. (2012) studied this question.
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