PRIMARY ALDOSTERONISM DETECTED AFTER RENAL-TRANSPLANTATION

A 44-year old female was admitted to our hospital for evaluation of un controlled hypertension. She received renal transplantation 3 months a go and suffered from a tingling sensation and weakness on both hands. Laboratory findings (low serum potassium, low plasma renin activity an d elevated plasma aldosterone level) was consistent with primary aldos teronism. Through the postural study for plasma aldosterone and the ad renal CT finding we diagnosed this case as adrenal adenoma, which was confirmed by surgical removal. A retrospective review of medical recor ds showed that characteristic findings in primary aldosteronism (hypok alemia and low plasma renin activity) were masked by renal failure and became evident after successful renal transplantation. It was suggest ed that impaired urinary potassium excretion and excess release of ren in from the ischemic kidney masked the characteristic findings of prim ary aldosteronism. To our knowledge, this is the first report document ing the change of renin-angiotensin-aldosterone system after renal tra nsplantation in a case of coexistence of primary aldosteronism and chr onic renal failure.