{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T13:50:21Z","timestamp":1792590621951,"version":"4.5.0"},"reference-count":60,"publisher":"Bioscientifica","issue":"3","license":[{"start":{"date-parts":[[2024,1,30]],"date-time":"2024-01-30T00:00:00Z","timestamp":1706572800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["ec.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,1,30]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Hypoaldosteronism is characterized by hyperkalemia, and\/or hypovolemic hyponatremia (HH), often accompanied by metabolic acidosis. HH is typical of hypoaldosteronism, whereas euvolemic hyponatremia (EH) is not. The purpose of the current study is to describe the characteristics of hyponatremia in hypoaldosteronism and elucidate whether EH can be considered part of the disease\u2019s spectrum.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In a hypoaldosteronism cohort, we analyzed the factors associated with hyponatremia, comparing the characteristics of EH and HH and their associated factors. Correlation analyses of mineralocorticoid biomarkers, such as the transtubular potassium gradient (TTKG), the urinary Na+\/K+ ratio (UNa+\/UK+) with serum, and urinary electrolytes were performed in both types of hyponatremia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 112 hypoaldosteronism episodes, 77.7% were \u226565 years old, 44.6% were women, and 80 (71.4%) had hyponatremia. Hyponatremia was negatively associated with the presence of chronic kidney disease, and positively with a hypovolemic state, malnutrition, a prior history of hyponatremia, and glucocorticoid therapy. HH: 61\/80 and EH: 19\/80 episodes. HH was associated with an age \u226565 years and the use of diuretics, as well as factors related to an aldosterone deficit and\/or mineralocorticoid resistance. In HH but not in EH, urinary potassium was correlated with the TTKG, and urinary sodium with both the TTKG and the UNa+\/UK+.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Both HH and EH can be observed in hypoaldosteronism. However, only the former would be related to insufficient mineralocorticoid activity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance statement<\/jats:title>\n                    <jats:p>Isolated hypoaldosteronism is a poorly understood and underdiagnosed endocrinological disorder, classically recognized only when hyperkalemia is present. The development of hypovolemic hyponatremia, however, is also easily explained by the physiopathology of the disorder. The current study addresses the features of hyponatremia when found in the context of mineralocorticoid insufficiency, and confirms an association between hypovolemic hyponatremia and isolated hypoaldosteronism. Thus, the clinical spectrum of hypoaldosteronism is extended to include hypovolemic hyponatremia as a frequent manifestation of the disorder.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1530\/ec-23-0430","type":"journal-article","created":{"date-parts":[[2024,1,30]],"date-time":"2024-01-30T07:21:55Z","timestamp":1706599315000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-10","source":"Crossref","is-referenced-by-count":4,"title":["Isolated hypoaldosteronism is a cause of hypovolemic but not euvolemic hyponatremia"],"prefix":"10.1530","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1305-9354","authenticated-orcid":true,"given":"Jorge Gabriel","family":"Ruiz-S\u00e1nchez","sequence":"first","affiliation":[{"name":"Servicio de Endocrinolog\u00eda y Nutrici\u00f3n. Instituto de Investigaci\u00f3n Sanitaria Fundaci\u00f3n Jim\u00e9nez D\u00edaz (IIS-FJD, UAM), Hospital Universitario Fundaci\u00f3n Jim\u00e9nez D\u00edaz, Madrid, Espa\u00f1a"},{"name":"Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Espa\u00f1a"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfonso Luis","family":"Calle-Pascual","sequence":"additional","affiliation":[{"name":"Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Espa\u00f1a"},{"name":"Servicio de Endocrinolog\u00eda y Nutrici\u00f3n. Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), Hospital Cl\u00ednico San Carlos, Madrid, Espa\u00f1a"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Diabetes y Enfermedades Metab\u00f3licas Asociadas (CIBERDEM), Madrid, Espa\u00f1a"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel \u00c1ngel","family":"Rubio-Herrera","sequence":"additional","affiliation":[{"name":"Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Espa\u00f1a"},{"name":"Servicio de Endocrinolog\u00eda y Nutrici\u00f3n. Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), Hospital Cl\u00ednico San Carlos, Madrid, Espa\u00f1a"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Paz","family":"De Miguel Novoa","sequence":"additional","affiliation":[{"name":"Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Espa\u00f1a"},{"name":"Servicio de Endocrinolog\u00eda y Nutrici\u00f3n. Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), Hospital Cl\u00ednico San Carlos, Madrid, Espa\u00f1a"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilia","family":"G\u00f3mez-Hoyos","sequence":"additional","affiliation":[{"name":"Servicio de Endocrinolog\u00eda y Nutrici\u00f3n, Hospital Cl\u00ednico Universitario de Valladolid, Valladolid, Espa\u00f1a"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"Runkle","sequence":"additional","affiliation":[{"name":"Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Espa\u00f1a"},{"name":"Servicio de Endocrinolog\u00eda y Nutrici\u00f3n. Instituto de Investigaci\u00f3n Sanitaria del Hospital Cl\u00ednico San Carlos (IdISSC), Hospital Cl\u00ednico San Carlos, Madrid, Espa\u00f1a"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"bib1","series-title":"Best Practice and Research. Clinical Endocrinology and Metabolism","first-page":"575","article-title":"Cortisol and the renal handling of electrolytes: role in glucocorticoid-induced hypertension and bone disease","volume":"17","author":"Ferrari","year":"2003","unstructured":"Ferrari P. Cortisol and the renal handling of electrolytes: role in glucocorticoid-induced hypertension and bone disease. Best Practice and Research. Clinical Endocrinology and Metabolism200317575\u2013589. (https:\/\/doi.org\/10.1016\/s1521-690x(0300053-8)"},{"key":"bib2","series-title":"Journal of Endocrinology","first-page":"T35","article-title":"30 YEARS OF THE MINERALOCORTICOID RECEPTOR: mineralocorticoid receptor and NaCl transport mechanisms in the renal distal nephron","volume":"234","author":"Shibata","year":"2017","unstructured":"Shibata S. 30 YEARS OF THE MINERALOCORTICOID RECEPTOR: mineralocorticoid receptor and NaCl transport mechanisms in the renal distal nephron. Journal of Endocrinology2017234T35\u2013T47. (https:\/\/doi.org\/10.1530\/JOE-16-0669)"},{"key":"bib3","series-title":"Endotext","article-title":"Aldosterone deficiency and resistance","author":"Arai","year":"2000","unstructured":"Arai KPapadopoulou-Marketou N & Chrousos GP. Aldosterone deficiency and resistance. In Endotext, eds. Feingold KRAnawalt BBoyce AChrousos GDungan KGrossman AHershman JMKaltsas GKoch CKopp P, et al.South Dartmouth,MA, USA: MDText.com, Inc. 2000. (available at: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK279079\/)"},{"key":"bib4","series-title":"StatPearls","article-title":"Hypoaldosteronism","author":"Rajkumar","year":"2021","unstructured":"Rajkumar V & Waseem M. Hypoaldosteronism. In StatPearls. Treasure Island,FL, USA: StatPearls2021. (available at: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK555992\/)"},{"key":"bib5","series-title":"Clinical Physiology of Acid-Base and Electrolyte Disorders","author":"Rose","year":"2001","unstructured":"Rose B & Post TClinical Physiology of Acid-Base and Electrolyte Disorders, 5th ed.New York, NY, USA: McGraw-Hill Education2001."},{"key":"bib6","series-title":"Frontiers in Endocrinology","first-page":"990148","article-title":"Clinical manifestations and associated factors in acquired hypoaldosteronism in endocrinological practice","volume":"13","author":"Ruiz-S\u00e1nchez","year":"2022","unstructured":"Ruiz-S\u00e1nchez JGCalle-Pascual ALRubio-Herrera M\u00c1De Miguel Novoa MPG\u00f3mez-Hoyos E & Runkle I. Clinical manifestations and associated factors in acquired hypoaldosteronism in endocrinological practice. Frontiers in Endocrinology202213990148. (https:\/\/doi.org\/10.3389\/fendo.2022.990148)"},{"key":"bib7","series-title":"Endocrine Practice","first-page":"957","article-title":"Selective hypoaldosteronism: a review","volume":"21","author":"Wilczynski","year":"2015","unstructured":"Wilczynski CShah LEmanuele MAEmanuele N & Mazhari A. Selective hypoaldosteronism: a review. Endocrine Practice201521957\u2013965. (https:\/\/doi.org\/10.4158\/EP14551.RA)"},{"key":"bib8","series-title":"Clinical Endocrinology","first-page":"706","article-title":"Renal tubular acidosis type IV in hyperkalaemic patients--a fairy tale or reality?","volume":"78","author":"Haas","year":"2013","unstructured":"Haas CSPohlenz ILindner UMuck PMArand JSuefke S & Lehnert H. Renal tubular acidosis type IV in hyperkalaemic patients--a fairy tale or reality?Clinical Endocrinology201378706\u2013711. (https:\/\/doi.org\/10.1111\/j.1365-2265.2012.04446.x)"},{"key":"bib9","series-title":"Iranian Journal of Kidney Diseases","first-page":"277","article-title":"Trimethoprim-sulfamethoxazole induced hyponatremia and hyperkalemia, the necessity of electrolyte follow-up in every patient","volume":"13","author":"Khorvash","year":"2019","unstructured":"Khorvash FMoeinzadeh FSaffaei A & Hakamifard A. Trimethoprim-sulfamethoxazole induced hyponatremia and hyperkalemia, the necessity of electrolyte follow-up in every patient. Iranian Journal of Kidney Diseases201913277\u2013280."},{"key":"bib10","series-title":"Annals of Pharmacotherapy","first-page":"404","article-title":"Heparin-induced hyponatremia","volume":"38","author":"Norman","year":"2004","unstructured":"Norman NESneed AMBrown CEllis CAMinard G & Brown RO. Heparin-induced hyponatremia. Annals of Pharmacotherapy200438404\u2013407. (https:\/\/doi.org\/10.1345\/aph.1C442)"},{"key":"bib11","series-title":"American Journal of Kidney Diseases","first-page":"1188","article-title":"Trimethoprim-associated hyponatremia","volume":"62","author":"Babayev","year":"2013","unstructured":"Babayev RTerner SChandra SRadhakrishnan J & Mohan S. Trimethoprim-associated hyponatremia. American Journal of Kidney Diseases2013621188\u20131192. (https:\/\/doi.org\/10.1053\/j.ajkd.2013.06.007)"},{"key":"bib12","series-title":"Clinical Nephrology","first-page":"208","article-title":"Hyponatremia and hyperreninemic hypoaldosteronism in a critically ill patient: combination of insensitivity to angiotensin II and tubular unresponsiveness to mineralocorticoid","volume":"34","author":"Muto","year":"1990","unstructured":"Muto SFujisawa GNatsume TAsano YYaginuma THosoda S & Saito T. Hyponatremia and hyperreninemic hypoaldosteronism in a critically ill patient: combination of insensitivity to angiotensin II and tubular unresponsiveness to mineralocorticoid. Clinical Nephrology199034208\u2013213."},{"key":"bib13","series-title":"European Journal of Internal Medicine","first-page":"246","article-title":"Isolated hypoaldosteronism: an overlooked cause of hyponatraemia","volume":"18","author":"Talapatra","year":"2007","unstructured":"Talapatra IKalavalapalli S & Tymms DJ. Isolated hypoaldosteronism: an overlooked cause of hyponatraemia. European Journal of Internal Medicine200718246\u2013248. (https:\/\/doi.org\/10.1016\/j.ejim.2006.09.026)"},{"key":"bib14","series-title":"Internal Medicine","first-page":"175","article-title":"Hyponatremia in an elderly patient due to isolated hypoaldosteronism occurring after licorice withdrawal","volume":"56","author":"Hataya","year":"2017","unstructured":"Hataya YOba AYamashita T & Komatsu Y. Hyponatremia in an elderly patient due to isolated hypoaldosteronism occurring after licorice withdrawal. Internal Medicine201756175\u2013179. (https:\/\/doi.org\/10.2169\/internalmedicine.56.6438)"},{"key":"bib15","series-title":"Journal of Clinical Endocrinology and Metabolism","first-page":"85","article-title":"Hyponatremia with low urinary aldosterone occurring in an old woman","volume":"34","author":"Mellinger","year":"1972","unstructured":"Mellinger RCPetermann FL & Jurgenson JC. Hyponatremia with low urinary aldosterone occurring in an old woman. Journal of Clinical Endocrinology and Metabolism19723485\u201391. (https:\/\/doi.org\/10.1210\/jcem-34-1-85)"},{"key":"bib16","series-title":"Journal of Clinical Endocrinology and Metabolism","first-page":"867","article-title":"Hyperreninemic hypoaldosteronism in the critically ill: a new entity","volume":"53","author":"Zipser","year":"1981","unstructured":"Zipser RDDavenport MWMartin KLTuck MLWarner NESwinney RRDavis CL & Horton R. Hyperreninemic hypoaldosteronism in the critically ill: a new entity. Journal of Clinical Endocrinology and Metabolism198153867\u2013873. (https:\/\/doi.org\/10.1210\/jcem-53-4-867)"},{"key":"bib17","series-title":"DICP","first-page":"244","article-title":"Heparin-induced hyperkalemia","volume":"24","author":"Aull","year":"1990","unstructured":"Aull LChao H & Coy K. Heparin-induced hyperkalemia. DICP199024244\u2013246. (https:\/\/doi.org\/10.1177\/106002809002400305)"},{"key":"bib18","series-title":"Internal Medicine","first-page":"96","article-title":"Severe hyponatremia and hyperkalemia Induced by trimethoprim-sulfamethoxazole in Patients with pneumocystis carinii pneumonia","volume":"34","author":"Noto","year":"1995","unstructured":"Noto HKaneko YTakano T & Kurokawa K. Severe hyponatremia and hyperkalemia Induced by trimethoprim-sulfamethoxazole in Patients with pneumocystis carinii pneumonia. Internal Medicine19953496\u201399. (https:\/\/doi.org\/10.2169\/internalmedicine.34.96)"},{"key":"bib19","series-title":"Internal Medicine","first-page":"665","article-title":"Hyponatremia and\/or hyperkalemia in Patients Treated with the Standard Dose of trimethoprim-sulfamethoxazole","volume":"42","author":"Mori","year":"2003","unstructured":"Mori HKuroda YImamura SToyoda AYoshida IKawakami M & Tabei K. Hyponatremia and\/or hyperkalemia in Patients Treated with the Standard Dose of trimethoprim-sulfamethoxazole. Internal Medicine200342665\u2013669. (https:\/\/doi.org\/10.2169\/internalmedicine.42.665)"},{"key":"bib20","series-title":"Journal of the Formosan Medical Association","first-page":"248","article-title":"Diagnostic value of plasma aldosterone\/potassium ratio in hypoaldosteronism","volume":"94","author":"Shiah","year":"1995","unstructured":"Shiah CJWu KDTsai DMLiao STSiauw CP & Lee LS. Diagnostic value of plasma aldosterone\/potassium ratio in hypoaldosteronism. Journal of the Formosan Medical Association199594248\u2013254."},{"key":"bib21","series-title":"Annals of Internal Medicine","first-page":"187","article-title":"Hyponatremia responsive to fludrocortisone acetate in elderly patients after head injury","volume":"106","author":"Ishikawa","year":"1987","unstructured":"Ishikawa SESaito TKaneko KOkada K & Kuzuya T. Hyponatremia responsive to fludrocortisone acetate in elderly patients after head injury. Annals of Internal Medicine1987106187\u2013191. (https:\/\/doi.org\/10.7326\/0003-4819-106-2-187)"},{"key":"bib22","series-title":"Medicine","first-page":"e7154","article-title":"Mineralocorticoid responsive hyponatremia of the elderly: a systematic review","volume":"96","author":"Katayama","year":"2017","unstructured":"Katayama K & Tokuda Y. Mineralocorticoid responsive hyponatremia of the elderly: a systematic review. Medicine201796e7154. (https:\/\/doi.org\/10.1097\/MD.0000000000007154)"},{"key":"bib23","series-title":"New England Journal of Medicine","first-page":"529","article-title":"Hypoaldosteronism; a clinical study of a patient with an isolated adrenal mineralocorticoid deficiency, resulting in hyperkalemia and Stokes-Adams attacks","volume":"257","author":"Hudson","year":"1957","unstructured":"Hudson JBChobanian AV & Relman AS. Hypoaldosteronism; a clinical study of a patient with an isolated adrenal mineralocorticoid deficiency, resulting in hyperkalemia and Stokes-Adams attacks. New England Journal of Medicine1957257529\u2013536. (https:\/\/doi.org\/10.1056\/NEJM195709192571201)"},{"key":"bib24","series-title":"Clinical Endocrinology","first-page":"836","article-title":"The contribution of undiagnosed adrenal insufficiency to euvolaemic hyponatraemia: results of a large prospective single-centre study","volume":"85","author":"Cuesta","year":"2016","unstructured":"Cuesta MGarrahy ASlattery DGupta SHannon AMForde HMcGurren KSherlock MTormey W & Thompson CJ. The contribution of undiagnosed adrenal insufficiency to euvolaemic hyponatraemia: results of a large prospective single-centre study. Clinical Endocrinology201685836\u2013844. (https:\/\/doi.org\/10.1111\/cen.13128)"},{"key":"bib25","series-title":"American Journal of Medicine","first-page":"399","article-title":"Hyponatremia: evaluating the correction factor for hyperglycemia","volume":"106","author":"Hillier","year":"1999","unstructured":"Hillier TAAbbott RD & Barrett EJ. Hyponatremia: evaluating the correction factor for hyperglycemia. American Journal of Medicine1999106399\u2013403. (https:\/\/doi.org\/10.1016\/S0002-9343(9900055-8)"},{"key":"bib26","series-title":"Reviews in Clinical Gerontology","first-page":"31","article-title":"Hyponatraemia in older patients: a clinical and practical approach","volume":"25","author":"Runkle","year":"2015","unstructured":"Runkle IGomez-Hoyos ECuesta-Hern\u00e1ndez MChafer-Vilaplana J & Miguel de P. Hyponatraemia in older patients: a clinical and practical approach. Reviews in Clinical Gerontology20152531\u201352. (https:\/\/doi.org\/10.1017\/S0959259814000197)"},{"key":"bib27","series-title":"Medicina","first-page":"851","article-title":"Changes in serum creatinine levels can help distinguish hypovolemic from euvolemic hyponatremia","volume":"58","author":"Ruiz-S\u00e1nchez","year":"2022","unstructured":"Ruiz-S\u00e1nchez JGCuesta MG\u00f3mez-Hoyos EC\u00e1rdenas-Salas JRubio-Herrera M\u00c1Mart\u00ednez-Gonz\u00e1lez EMiguel Novoa De PTernero-Vega JECalle-Pascual AL & Runkle I. Changes in serum creatinine levels can help distinguish hypovolemic from euvolemic hyponatremia. Medicina202258851. (https:\/\/doi.org\/10.3390\/medicina58070851)"},{"key":"bib28","series-title":"Endocrinologia, Diabetes y Nutricion","article-title":"Consensus document on the management of hyponatraemia of the Acqua Group of the Spanish Society of Endocrinology and Nutrition","author":"Barajas Galindo","year":"2022","unstructured":"Barajas Galindo DERuiz-S\u00e1nchez JGFern\u00e1ndez Mart\u00ednez Ade la Vega IRFerrer Garc\u00eda JCRopero-Luis GOrtol\u00e1 Buigues ASerrano Gotarredona J & G\u00f3mez Hoyos E. Consensus document on the management of hyponatraemia of the Acqua Group of the Spanish Society of Endocrinology and Nutrition. Endocrinologia, Diabetes y Nutricion2022. (https:\/\/doi.org\/10.1016\/j.endien.2022.11.006)"},{"key":"bib29","series-title":"American Journal of Nephrology","first-page":"360","article-title":"Renal potassium handling during states of low aldosterone bio-activity: a method to differentiate renal and non-renal causes","volume":"7","author":"Zettle","year":"1987","unstructured":"Zettle RMWest MLJosse RGRichardson RMAMarsden PA & Halperin ML. Renal potassium handling during states of low aldosterone bio-activity: a method to differentiate renal and non-renal causes. American Journal of Nephrology19877360\u2013366. (https:\/\/doi.org\/10.1159\/000167502)"},{"key":"bib30","series-title":"Journal of the American Society of Nephrology","first-page":"1279","article-title":"Studies to determine the basis for hyperkalemia in recipients of a renal transplant who are treated with cyclosporine","volume":"2","author":"Kamel","year":"1992","unstructured":"Kamel KSEthier JHQuaggin SLevin AAlbert SCarlisle EJ & Halperin ML. Studies to determine the basis for hyperkalemia in recipients of a renal transplant who are treated with cyclosporine. Journal of the American Society of Nephrology199221279\u20131284. (https:\/\/doi.org\/10.1681\/ASN.V281279)"},{"key":"bib31","series-title":"American Journal of Nephrology","first-page":"89","article-title":"Urine electrolytes and osmolality: when and how to use them","volume":"10","author":"Kamel","year":"1990","unstructured":"Kamel KSEthier JHRichardson RMABear RA & Halperin ML. Urine electrolytes and osmolality: when and how to use them. American Journal of Nephrology19901089\u2013102. (https:\/\/doi.org\/10.1159\/000168062)"},{"key":"bib32","series-title":"American Journal of Kidney Diseases","first-page":"47","article-title":"Effect of mineralocorticoid activity on transtubular potassium gradient, urinary [K]\/[Na] ratio, and fractional excretion of potassium","volume":"32","author":"Chacko","year":"1998","unstructured":"Chacko MFordtran JS & Emmett M. Effect of mineralocorticoid activity on transtubular potassium gradient, urinary [K]\/[Na] ratio, and fractional excretion of potassium. American Journal of Kidney Diseases19983247\u201351. (https:\/\/doi.org\/10.1053\/ajkd.1998.v32.pm9669423)"},{"key":"bib33","series-title":"Mineral and Electrolyte Metabolism","first-page":"226","article-title":"Development of a test to evaluate the transtubular potassium concentration gradient in the cortical collecting duct in vivo","volume":"12","author":"West","year":"1986","unstructured":"West MLBendz OChen CBSinger GGRichardson RMSonnenberg H & Halperin ML. Development of a test to evaluate the transtubular potassium concentration gradient in the cortical collecting duct in vivo. Mineral and Electrolyte Metabolism198612226\u2013233."},{"key":"bib34","series-title":"Mineral and Electrolyte Metabolism","first-page":"234","article-title":"New clinical approach to evaluate disorders of potassium excretion","volume":"12","author":"West","year":"1986","unstructured":"West MLMarsden PARichardson RMZettle RM & Halperin ML. New clinical approach to evaluate disorders of potassium excretion. Mineral and Electrolyte Metabolism198612234\u2013238."},{"key":"bib35","series-title":"Nephron","first-page":"56","article-title":"Trans-tubular potassium gradient in patients with drug-induced hyperkalemia","volume":"89","author":"Mayan","year":"2001","unstructured":"Mayan HKantor R & Farfel Z. Trans-tubular potassium gradient in patients with drug-induced hyperkalemia. Nephron20018956\u201361. (https:\/\/doi.org\/10.1159\/000046044)"},{"key":"bib36","series-title":"Saudi Journal of Kidney Diseases and Transplantation","first-page":"551","article-title":"Correlation between creatinine clearance and transtubular potassium concentration gradient in old people and chronic renal disease patients","volume":"18","author":"Musso","year":"2007","unstructured":"Musso CLiakopoulos VStefanidis IMiguel De RImperiali N & Algranati L. Correlation between creatinine clearance and transtubular potassium concentration gradient in old people and chronic renal disease patients. Saudi Journal of Kidney Diseases and Transplantation200718551\u2013555."},{"key":"bib37","series-title":"American Journal of Kidney Diseases","first-page":"309","article-title":"The transtubular potassium concentration in patients with hypokalemia and hyperkalemia","volume":"15","author":"Ethier","year":"1990","unstructured":"Ethier JHKamel KSMagner POLemann J & Halperin ML. The transtubular potassium concentration in patients with hypokalemia and hyperkalemia. American Journal of Kidney Diseases199015309\u2013315. (https:\/\/doi.org\/10.1016\/s0272-6386(1280076-x)"},{"key":"bib38","series-title":"International Urology and Nephrology","first-page":"387","article-title":"Transtubular potassium concentration gradient: comparison between healthy old people and chronic renal failure patients","volume":"38","author":"Musso","year":"2006","unstructured":"Musso CLiakopoulos VDe RImperiali N & Algranati L. Transtubular potassium concentration gradient: comparison between healthy old people and chronic renal failure patients. International Urology and Nephrology200638387\u2013390. (https:\/\/doi.org\/10.1007\/s11255-006-0059-5)"},{"key":"bib39","series-title":"Pediatric Nephrology","first-page":"105","article-title":"Transtubular potassium concentration gradient: a useful test to estimate renal aldosterone bio-activity in infants and children","volume":"4","author":"Rodr\u00edguez-Soriano","year":"1990","unstructured":"Rodr\u00edguez-Soriano JUbetagoyena M & Vallo A. Transtubular potassium concentration gradient: a useful test to estimate renal aldosterone bio-activity in infants and children. Pediatric Nephrology19904105\u2013110. (https:\/\/doi.org\/10.1007\/BF00858819)"},{"key":"bib40","series-title":"Journal of the American Society of Nephrology","first-page":"424","article-title":"The utility of the transtubular potassium gradient in the evaluation of hyperkalemia","volume":"19","author":"Choi","year":"2008","unstructured":"Choi MJ & Ziyadeh FN. The utility of the transtubular potassium gradient in the evaluation of hyperkalemia. Journal of the American Society of Nephrology200819424\u2013426. (https:\/\/doi.org\/10.1681\/ASN.2007091017)"},{"key":"bib41","series-title":"Journal of Endocrinology","first-page":"425","article-title":"Urinary excretion of sodium and potassium in relation to plasma aldosterone concentration","volume":"53","author":"Adamson","year":"1972","unstructured":"Adamson AR & Jamieson SW. Urinary excretion of sodium and potassium in relation to plasma aldosterone concentration. Journal of Endocrinology197253425\u2013431. (https:\/\/doi.org\/10.1677\/joe.0.0530425)"},{"key":"bib42","series-title":"Journal of Translational Medicine","first-page":"180","article-title":"The use of plasma aldosterone and urinary sodium to potassium ratio as translatable quantitative biomarkers of mineralocorticoid receptor antagonism","volume":"9","author":"Eudy","year":"2011","unstructured":"Eudy RJSahasrabudhe VSweeney KTugnait MKing-Ahmad ANear KLoria PBanker MEPiotrowski DW & Boustany-Kari CM. The use of plasma aldosterone and urinary sodium to potassium ratio as translatable quantitative biomarkers of mineralocorticoid receptor antagonism. Journal of Translational Medicine20119180. (https:\/\/doi.org\/10.1186\/1479-5876-9-180)"},{"key":"bib43","series-title":"Kidney International","first-page":"942","article-title":"Early and late adjustment to potassium loading in humans","volume":"38","author":"Rabelink","year":"1990","unstructured":"Rabelink TJKoomans HAHen\u00e9 RJ & Mees EJD. Early and late adjustment to potassium loading in humans. Kidney International199038942\u2013947. (https:\/\/doi.org\/10.1038\/ki.1990.295)"},{"key":"bib44","series-title":"Endocrinology and Metabolism Clinics of North America","first-page":"349","article-title":"Age-associated abnormalities of water homeostasis","volume":"42","author":"Cowen","year":"2013","unstructured":"Cowen LEHodak SP & Verbalis JG. Age-associated abnormalities of water homeostasis. Endocrinology and Metabolism Clinics of North America201342349\u2013370. (https:\/\/doi.org\/10.1016\/j.ecl.2013.02.005)"},{"key":"bib45","series-title":"BMJ Case Reports","first-page":"e239543","article-title":"Cotrimoxazole-induced hyperkalaemia in a patient with known hypoaldosteronism","volume":"14","author":"Montebello","year":"2021","unstructured":"Montebello A & Gruppetta M. Cotrimoxazole-induced hyperkalaemia in a patient with known hypoaldosteronism. BMJ Case Reports202114e239543. (https:\/\/doi.org\/10.1136\/bcr-2020-239543)"},{"key":"bib46","series-title":"Endocrine Abstracts","first-page":"EP38","article-title":"Moderate\/severe hypovolemic hyponatremia with urinary sodium loss secondary to hypoaldosteronism: analysis of 28 cases","volume":"41","author":"Penso","year":"2016","unstructured":"Penso ROrtola AAmengual ACrespo IRuiz-Gracia TCuesta-Hernandez MGomez-Hoyos EMarcuello CCalle A & Runkle I. Moderate\/severe hypovolemic hyponatremia with urinary sodium loss secondary to hypoaldosteronism: analysis of 28 cases. Endocrine Abstracts201641EP38. (https:\/\/doi.org\/10.1530\/endoabs.41.EP38)"},{"key":"bib47","series-title":"Acta Physiologica Scandinavica","first-page":"242","article-title":"Blood pressure regulation, peripheral renin activity and aldosterone in patients with pyelonephritic renal scarring","volume":"131","author":"Jacobson","year":"1987","unstructured":"Jacobson SH. Blood pressure regulation, peripheral renin activity and aldosterone in patients with pyelonephritic renal scarring. Acta Physiologica Scandinavica1987131242\u2013248. (https:\/\/doi.org\/10.1111\/j.1748-1716.1987.tb08233.x)"},{"key":"bib48","series-title":"Pathology, Research and Practice","first-page":"324","article-title":"Changes in blood cortisol and aldosterone levels and ultrastructure of the adrenal cortex during hemorrhagic shock","volume":"176","author":"Kajihara","year":"1983","unstructured":"Kajihara HMalliwah JAMatsumura MTaguchi K & Iijima S. Changes in blood cortisol and aldosterone levels and ultrastructure of the adrenal cortex during hemorrhagic shock. Pathology, Research and Practice1983176324\u2013340. (https:\/\/doi.org\/10.1016\/S0344-0338(8380022-3)"},{"key":"bib49","series-title":"Journal of Clinical Investigation","first-page":"1","article-title":"Responses of adrenal corticosteroid secretion to hypotension and hypovolemia","volume":"44","author":"Gann","year":"1965","unstructured":"Gann DS & Egdahl RH. Responses of adrenal corticosteroid secretion to hypotension and hypovolemia. Journal of Clinical Investigation1965441\u20137. (https:\/\/doi.org\/10.1172\/JCI105116)"},{"key":"bib50","series-title":"Frontiers in Endocrinology","first-page":"422","article-title":"Magnocellular vasopressin and the mechanism of \u2018glucocorticoid escape\u2019","volume":"10","author":"Antoni","year":"2019","unstructured":"Antoni FA. Magnocellular vasopressin and the mechanism of \u2018glucocorticoid escape\u2019. Frontiers in Endocrinology201910422. (https:\/\/doi.org\/10.3389\/fendo.2019.00422)"},{"key":"bib51","series-title":"American Journal of Physiology","first-page":"R161","article-title":"AVP-eGFP was significantly upregulated by hypovolemia in the parvocellular division of the paraventricular nucleus in the transgenic rats","volume":"322","author":"Sanada","year":"2022","unstructured":"Sanada KUeno HMiyamoto TBaba KTanaka KNishimura HNishimura KSonoda SYoshimura MMaruyama T, et al. AVP-eGFP was significantly upregulated by hypovolemia in the parvocellular division of the paraventricular nucleus in the transgenic rats. American Journal of Physiology2022322R161\u2013R169. (https:\/\/doi.org\/10.1152\/ajpregu.00107.2021)"},{"key":"bib52","series-title":"Endocrinology","first-page":"1417","article-title":"Arginine vasopressin stimulates atrial natriuretic peptide gene expression and secretion from rat diencephalic neurons","volume":"131","author":"Levin","year":"1992","unstructured":"Levin ERHu RMRossi M & Pickart M. Arginine vasopressin stimulates atrial natriuretic peptide gene expression and secretion from rat diencephalic neurons. Endocrinology19921311417\u20131423. (https:\/\/doi.org\/10.1210\/endo.131.3.1380442)"},{"key":"bib53","series-title":"Science","first-page":"395","article-title":"Vasopressin-stimulated release of atriopeptin: endocrine antagonists in fluid homeostasis","volume":"229","author":"Manning","year":"1985","unstructured":"Manning PTSchwartz DKatsube NCHolmberg SW & Needleman P. Vasopressin-stimulated release of atriopeptin: endocrine antagonists in fluid homeostasis. Science1985229395\u2013397. (https:\/\/doi.org\/10.1126\/science.2990050)"},{"key":"bib54","series-title":"Journal of Clinical Endocrinology and Metabolism","first-page":"1385","article-title":"Atrial natriuretic peptide in patients with the syndrome of inappropriate antidiuretic hormone secretion and with diabetes insipidus","volume":"70","author":"Kamoi","year":"1990","unstructured":"Kamoi KEbe TKobayashi OIshida MSato FArai OTamura TTakagi AYamada A & Ishibashi M. Atrial natriuretic peptide in patients with the syndrome of inappropriate antidiuretic hormone secretion and with diabetes insipidus. Journal of Clinical Endocrinology and Metabolism1990701385\u20131390. (https:\/\/doi.org\/10.1210\/jcem-70-5-1385)"},{"key":"bib55","series-title":"Journal of Endocrinology","first-page":"39","article-title":"Atriopeptins are potent inhibitors of ACTH secretion by rat anterior pituitary cells in vitro: involvement of the atrial natriuretic factor receptor domain of membrane-bound guanylyl cyclase","volume":"125","author":"Dayanithi","year":"1990","unstructured":"Dayanithi G & Antoni FA. Atriopeptins are potent inhibitors of ACTH secretion by rat anterior pituitary cells in vitro: involvement of the atrial natriuretic factor receptor domain of membrane-bound guanylyl cyclase. Journal of Endocrinology199012539\u201344. (https:\/\/doi.org\/10.1677\/joe.0.1250039)"},{"key":"bib56","series-title":"Endocrinology","first-page":"1753","article-title":"Atriopeptin: an endogenous corticotropin-release inhibiting hormone","volume":"130","author":"Antoni","year":"1992","unstructured":"Antoni FAHunter EFLowry PJNoble JM & Seckl JR. Atriopeptin: an endogenous corticotropin-release inhibiting hormone. Endocrinology19921301753\u20131755. (https:\/\/doi.org\/10.1210\/endo.130.3.1311248)"},{"key":"bib57","series-title":"American Journal of Kidney Diseases","first-page":"296","article-title":"Hyperkalemia in the elderly","volume":"16","author":"Michelis","year":"1990","unstructured":"Michelis MF. Hyperkalemia in the elderly. American Journal of Kidney Diseases199016296\u2013299. (https:\/\/doi.org\/10.1016\/S0272-6386(1280005-9)"},{"key":"bib58","series-title":"Annals of Pharmacotherapy","first-page":"1618","article-title":"An evaluation of hyperkalemia and serum creatinine elevation associated with different dosage levels of outpatient trimethoprim-sulfamethoxazole with and without concomitant medications","volume":"47","author":"Gentry","year":"2013","unstructured":"Gentry CA & Nguyen AT. An evaluation of hyperkalemia and serum creatinine elevation associated with different dosage levels of outpatient trimethoprim-sulfamethoxazole with and without concomitant medications. Annals of Pharmacotherapy2013471618\u20131626. (https:\/\/doi.org\/10.1177\/1060028013509973)"},{"key":"bib59","series-title":"Journal of the American Society of Nephrology","first-page":"1459","article-title":"Aldosterone responses to hyperkalemia in healthy elderly humans","volume":"6","author":"Mulkerrin","year":"1995","unstructured":"Mulkerrin EEpstein FH & Clark BA. Aldosterone responses to hyperkalemia in healthy elderly humans. Journal of the American Society of Nephrology199561459\u20131462. (https:\/\/doi.org\/10.1681\/ASN.V651459)"},{"key":"bib60","series-title":"Journal of Steroid Biochemistry and Molecular Biology","first-page":"105361","article-title":"Expression of aldosterone synthase CYP11B2 was inversely correlated with longevity","volume":"191","author":"Hayashi","year":"2019","unstructured":"Hayashi TZhang ZAl-Eyd GSasaki AYasuda MOyama MGomez-Sanchez CEAsakura HSeki TMukai K, et al. Expression of aldosterone synthase CYP11B2 was inversely correlated with longevity. Journal of Steroid Biochemistry and Molecular Biology2019191105361. (https:\/\/doi.org\/10.1016\/j.jsbmb.2019.04.010)"}],"container-title":["Endocrine Connections"],"original-title":[],"link":[{"URL":"https:\/\/ec.bioscientifica.com\/view\/journals\/ec\/13\/3\/EC-23-0430.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/ec.bioscientifica.com\/downloadpdf\/journals\/ec\/13\/3\/EC-23-0430.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/ec.bioscientifica.com\/downloadpdf\/journals\/ec\/13\/3\/EC-23-0430.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T13:46:59Z","timestamp":1784555219000},"score":1,"resource":{"primary":{"URL":"http:\/\/journals.bioscientifica.com\/ec\/article\/1292"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,30]]},"references-count":60,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.1530\/ec-23-0430","relation":{},"ISSN":["2049-3614"],"issn-type":[{"value":"2049-3614","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,30]]}}}