Schambelan's syndrome

A cause of hiperkalemia

Abstract

A case of hyperkalemia in a male patient with type 1 diabetes, hypertension, and renal dysfunction secondary to diabetic nephropathy is reported. He was on enalapril and it was initially thought that hyperkalemia was due to the treatment with this drug. Nontheless, initial management was unsuccessful as hyperkalemia did not resolve and subsequently a few sessions of hemodialysis were requiered because electrocardiographic-related changes. The whole analysis of clinical and laboratory data allowed to conclude that hyperkalemia was secondary to hyporeninemic hypoaldosteronism, and therefore conventional, medical management lead to notorius improvement in his metabolic disarrangement. As this case has shown, it is important to considerer non obvious, but usually frequent, causes of hyperkalemia in patients with moderate to severe renal dysfunction, especially if they are diabetic.