Work

Refractory hyponatremia secondary to idiopathic, isolated aldosterone deficiency

Year: 2026

Type: article

Abstract: Hypoaldosteronism is an uncommon, but well-recognized cause of hyponatremia. Hypoaldosteronism is often attributed to renin deficiency or primary adrenal insufficiency. Here, we present the case of a patient with recurrent, refractory hyponatremia due to hypoaldosteronism with normal serum renin activity and cortisol levels. He was started on fludrocortisone with normalization of electrolytes. This is a highly unusual case of hypoaldosteronism without perturbation to the renin-angiotensin system or adrenal insufficiency and serves as an important reminder that aldosterone deficiency should be considered as a potential cause of hyponatremia independent of renin activity or other markers of adrenal function.

Source: Oxford Medical Case Reports

DOI: 10.1093/omcr/omag062

Authors: Noah W Free, Anastasia E Metropulos, Jeremy R Williams, Prakash Balasubramanian, Daniel R Principe

Institutions: University of Wisconsin–Madison, Indiana University School of Medicine, William S. Middleton Memorial Veterans Hospital

Language: English

Topic: Electrolyte and hormonal disorders

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,103