RESUMEN
Mineralocorticoid deficiency (MD) with hyperkalemia is an important complication of adrenalectomy in patients with primary aldosteronism (PA). We herein report a 52-year-old man with refractory hypertension, hypokalemia, and severe renal dysfunction due to PA caused by a right adrenal adenoma. His estimated glomerular filtration rate (eGFR) transiently increased immediately after adrenalectomy but then gradually declined, and he developed hyperkalemia. A postoperative endocrine examination revealed MD. Considering the patient's hypertension and severe renal dysfunction, we administered hydrocortisone instead of fludrocortisone, which improved the hyperkalemia and stopped the decline in the eGFR. Alternative therapy with hydrocortisone may be useful in such patients with MD.
Asunto(s)
Hiperaldosteronismo , Hiperpotasemia , Hipertensión , Enfermedades Renales , Masculino , Humanos , Persona de Mediana Edad , Hiperpotasemia/etiología , Hidrocortisona/uso terapéutico , Hiperaldosteronismo/tratamiento farmacológico , Hiperaldosteronismo/cirugía , Hiperaldosteronismo/complicaciones , Hipertensión/etiología , Adrenalectomía , Enfermedades Renales/complicaciones , AldosteronaRESUMEN
Four new dammarane-type triterpene saponins named floranotoginsenosides A (1), B (2), C (3) and D (4), together with five known triterpene saponins, were isolated from the flowers of Panax notoginseng. Their structures were elucidated on the basis of spectral and chemical evidence.