Question

A 64-year-old man with a long history of gout and type 2 diabetes mellitus comes in for a routine checkup. Serum chemistries are as follows: sodium, 140 mEq/L; potassium, 6.3 mEq/L; bicarbonate, 18 mEq/L; BUN, 43 mg/dL; creatinine, 2.9 mg/dL; glucose, 198

A 64-year-old man with a long history of gout and type 2 diabetes mellitus comes in for a routine checkup. Serum chemistries are as follows: sodium, 140 mEq/L; potassium, 6.3 mEq/L; bicarbonate, 18 mEq/L; BUN, 43 mg/dL; creatinine, 2.9 mg/dL; glucose, 198 mg/dL. Chart review shows

previous potassium values of 5.3 mEq/L and 5.7 mEq/L. The patient is currently taking only colchicine, 0.5 mg daily, and glyburide, 5 mg twice daily.

Questions

A. What is the most likely cause of this patient’s hyperkalemia, and what is

     its pathogenesis?

B. What are other possible causes of hypoaldosteronism?

C. Plasma renin activity and aldosterone levels are sent to the laboratory.

    What results should be anticipated?


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A 64-year-old man with a long history of gout and type 2 diabetes mellitus comes in for a routine checkup. Serum chemistries are as follows: sodium, 140 mEq/L; potassium, 6.3 mEq/L; bicarbonate, 18 mEq/L; BUN, 43 mg/dL; creatinine, 2.9 mg/dL; glucose, 198
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