Persistent Hyperkalemia Status Postadrenalectomy for Primary Aldosteronism

ABSTRACT Objective: To report a rare case of persistent hyperkalemia and suppressed renin-aldosterone axis after adrenalectomy for an aldosterone-producing adenoma. Methods: We present the laboratory results, radiologic and surgical findings, and clinical course and management of a patient who had surgery to treat primary aldosteronism induced hypertension. Results: A 43-year-old male presented with hypertension and hypokalemia, and was diagnosed with primary aldosteronism with an aldosterone-producing adenoma. Adrenalectomy after localization was followed by delayed development of hyperkalemia with suppression of aldosterone requiring long-term mineralocorticoid replacement. Conclusion: This case illustrates the rare occurrence of persistent mineralocorticoid deficiency after adrenalectomy in a patient with confirmed primary hyperaldosteronism. Abbreviations: MRA = mineralocorticoid receptor antagonist PRA = plasma renin activity