A 64 year old man with long standing diabetes mellitus is evaluated for progressive weakness. Blood pressure is 148/88 mm Hg. Laboratory studies show potassium 6.0 mEq/L, bicarbonate 18 mEq/L, and a normal anion gap metabolic acidosis. Plasma renin and aldosterone levels are low. Which of the following is the most likely diagnosis?

  1. A)Type 4 renal tubular acidosisGABARITO
  2. B)Gitelman syndrome
  3. C)Type 2 renal tubular acidosis
  4. D)Type 1 renal tubular acidosis
  5. E)Bartter syndrome

Explicação

Type 4 renal tubular acidosis is correct. Hypoaldosteronism or aldosterone resistance reduces distal sodium reabsorption and potassium and hydrogen secretion, producing hyperkalemia and a normal anion gap metabolic acidosis. Diabetic hyporeninemic hypoaldoster... Ver explicação completa e trilha adaptativa →

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