Hyporeninemic Hypoaldosteronism in Sickle Cell Disease

Abstract

A patient with sickle cell disease and persistent hyperkalemia in the face of mild stable renal failure is described. The adrenal response to ACTH stimulation was intact, nonstimulated renin and aldosterone levels were markedly low and did not increase in response to stimulation using acute volume reduction. The hyperkalemia responded to mineralocorticoids. It is suggested that patients with sickle cell disease might be at risk of hyperkalemia due to impaired ability to excrete potassium loads and impaired renin secreting aparatus.