Reasons Why a Patient with Addison's Disease May Not Have Hyperkalemia

 

Reasons for an absence of hyperkalemia in a patient with Addison's disease:

(1) isolated deficiency of cortisol (presence of mineralocorticoid activity)

(2) increased renal loss of potassium (diuretic therapy, protracted vomiting, etc)

(3) shift of potassium into cells (insulin and glucose administration, etc)

(4) very low dietary intake of potassium

 

It is important to recognize the patient's with Addison's disease may lack the classic signs and symptoms.