In nondiabetic patients with chronic hyperkalemia and acidosis, causes of tubular resistance to aldosterone should be considered. Among them, urinary obstruction and sickle cell nephropathy are most common. This case illustrates the importance of recognizing urinary obstruction as a cause of distal renal tubular acidosis and hyperkalemia due to tubular unresponsiveness to aldosterone. The Newsletter is distributed monthly by the Internal Medicine Residency Program. Its purpose is to communicate news important to resident physicians, faculty, and staff.
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Deadline for news items to be included in the Newsletter is the 20 th of each month.