Na wasting results in a chronically low plasma volume reflected by a normal BP despite high renin and angiotensin levels and by an impaired pressor response to angiotensin infusion. Metabolic alkalosis often develops. Platelet aggregation is inhibited. Hyperuricemia and hypomagnesemia may occur. The kinin-prostaglandin axis is stimulated, and urinary excretion of prostaglandins and kallikrein is increased.
Affected children have poor growth rates and appear malnourished.
Muscle weakness, polydipsia, polyuria, and mental retardation may be present. In adult patients, bulimia nervosa, vomiting, or surreptitious diuretic or laxative abuse must be excluded as a cause. K supplementation plus spironolactone, triamterene, amiloride, an ACE inhibitor, or indomethacin will correct most features, but no drug completely eliminates K wasting. All rights reserved.