Normal GFR but with ↓ renal K excretion-hyperkalemia

Normal aldosterone function

• ↓ EAV (K excretion limited by ↓ distal Na delivery & urine flow): CHF, cirrhosis

• Excessive K intake: in conjunction with impairment in K excretion or transcellular shift

• Ureterojejunostomy (absorption of urinary K in jejunum)

Hypoaldosteronism

same as etiologies of hypoaldo RTA (type IV)

• ↓ renin: DM, NSAIDs, chronic interstitial nephritis, HIV, multiple myeloma, Gordon’s

• Normal renin, ↓ aldo synthesis: 1° adrenal disorders, ACEI, ARBs, heparin, ketoconazole

• ↓ response to aldosterone

• Meds: K-sparing diuretics, TMP-SMX, pentamidine, calcineurin inhibitors

• Tubulointerstitial disease: sickle cell, SLE, amyloid, diabetes