Plasma aldosterone in anephric and non-nephrectomized dialysis patients in relation to changes in plasma potassium without change in total potassium balance

Abstract

Plasma aldosterone concentration has been measured in 13 patients on regular hemodialysis, 7 anephric and 6 non-nephrectomized, following infusion of insulin-glucose. In all patients the plasma potassium fell about 16% within the first 60 min after the infusion, increasing again to about preinfusion levels within 180 min. All anephric patients showed a very low preinfusion value for plasma aldosterone (mean 33.3 pg/ml plasma), which increased significantly (p less than 0.01) after the infusion of insulin-glucose, to about 180% of the initial values, simultaneously with the fall in plasma potassium concentration. A significant inverse correlation (p less than 0.01) was found between changes in plasma aldosterone and potassium. The preinfusion in plasma aldosterone values were significantly higher (p less than 0.01) in the non-nephrectomized than in the anephric group--but of a wide range (26-700 pg/ml plasma). In this group the mean plasma aldosterone concentration showed a significant fall simultaneously with the fall in plasma potassium concentration, but with great variations between patients. There was a significant positive correlation (p less than 0.005) between the changes in plasma aldosterone and potassium. These studies indicate an extremely sensitive regulation of plasma aldosterone secretion in anephric patients, in all probability positively correlated to changes in intracellular adrenal potassium concentration.