Primary aldosteronism due to aldosterone-producing adrenocortical adenoma with high plasma renin activity and massive elevation of plasma aldosterone concentration in a maintained hemodialysis patient

Abstract

The patient was a 53-year-old woman on maintenance dialysis. High plasma renin activity (PRA) and high plasma aldosterone concentration (PAC) were noticed by chance, and she was closely examined. PAC was very high, 40,080pg/mL. A right adrenal tumor was thought to be an aldosterone-producing adenoma with renovascular PRA increase. Right adrenalectomy was performed and the PAC value decreased. It was thought that negative feedback did not occur because the factor controlling PAC secretion decreased, and easily reached a high value, although there is an example in which extremely high aldosterone developed due to renal failure. Moreover, it is necessary to assess whether there is a material that interferes the PAC measurement system in maintenance dialysis patients, and to evaluate it carefully.