Relation between potassium balance and aldosterone secretion in normal subjects and in patients with hypertensive or renal tubular disease.

Abstract

The aldosterojie secretory response io K administration was enhanced for 4 to 10-fold or more: after Na depletion in normal subjects or patients with essential hypertension; in patients receiving normal Na diets who had renal arterial stenosis, advanced or malignant hypertension, or renal tubular disease characterized by Na wasting; and in patients with primary aldosteronism. In these circumstances, the magnitude of the aldosterone response to K was equal or greater than that described for angiotensin. In the study of both normal and hypertensive subjects the degree of adrenal response was directly related to the pre-existing rate of aldosterone secretion regardless of whether the latter resulted from an autonomous tumor of from extra-adrenal stimulation presumably via renin. This conditioning of the stimulatory influence of Kupon aldosterone by the prior level of adrenal activity suggests that the regulation of aldosterone is normally controlled by a complementary interrelationship between more direct adrenotropic effects of K and activity of the renin-angiotensin system.