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Izumi Y, Nakayama Y, Onoue T, et al. Renal tubular acidosis complicated with hyponatremia due to cortisol insufficiency. Oxf Med Case Reports. 2015;2015(11):360-3doi: 10.1093/omcr/omv063.
Izumi, Y., Nakayama, Y., Onoue, T., Inoue, H., & Mukoyama, M. (2015). Renal tubular acidosis complicated with hyponatremia due to cortisol insufficiency. Oxford medical case reports, 2015(11), 360-3. https://doi.org/10.1093/omcr/omv063
Izumi, Yuichiro, et al. "Renal tubular acidosis complicated with hyponatremia due to cortisol insufficiency." Oxford medical case reports vol. 2015,11 (2015): 360-3. doi: https://doi.org/10.1093/omcr/omv063
Izumi Y, Nakayama Y, Onoue T, Inoue H, Mukoyama M. Renal tubular acidosis complicated with hyponatremia due to cortisol insufficiency. Oxf Med Case Reports. 2015 Nov 19;2015(11):360-3. doi: 10.1093/omcr/omv063. eCollection 2015 Nov. PMID: 26609420; PMCID: PMC4652059.
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Oxf Med Case Reports. 2015 Nov 19;2015(11):360-3. doi: 10.1093/omcr/omv063. eCollection 2015 Nov.

Renal tubular acidosis complicated with hyponatremia due to cortisol insufficiency.

Oxford medical case reports

Yuichiro Izumi, Yushi Nakayama, Tomoaki Onoue, Hideki Inoue, Masashi Mukoyama

Affiliations

  1. Department of Nephrology , Kumamoto University Graduate School of Medical Sciences , Kumamoto, Kumamoto , Japan.

PMID: 26609420 PMCID: PMC4652059 DOI: 10.1093/omcr/omv063

Abstract

Adrenocortical insufficiency such as occurs in Addison's disease causes hyponatremia and renal tubular acidosis (RTA). Hyponatremia results from both aldosterone and cortisol insufficiency. RTA is due to aldosterone insufficiency. The involvement of cortisol in RTA is unclear. Here, we report a woman in her 70s who was admitted to our hospital with severe hyponatremia (106 mEq/l) and RTA. The patient exhibited low plasma cortisol levels with little response to rapid adrenocorticotropic hormone loading. In contrast, the plasma aldosterone concentration was maintained at or above the normal range. Hydrocortisone replacement greatly improved both the hyponatremia and RTA. This case suggests that both aldosterone and cortisol are involved in acid secretion from the kidney.

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