Hiperaldosteronismo

Descripción General

Definición

Hiperaldosteronismo se define como un aumento de la secreción de aldosterona de la zona glomerulosa Zona Glomerulosa The narrow subcapsular outer zone of the adrenal cortex. This zone produces a series of enzymes that convert pregnenolone to aldosterone. The final steps involve three successive oxidations by cytochrome p-450 cyp11b2. Adrenal Glands: Anatomy de la corteza suprarrenal.

• Hiperaldosteronismo primario: secreción autónoma (independiente de la renina) de aldosterona
• Hiperaldosteronismo secundario: hipersecreción fisiológica de aldosterona que se produce en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum respuesta a la sobreestimulación del eje SRAA, desencadenada por la disminución del flujo sanguíneo renal.

Epidemiología

• Prevalencia del hiperaldosteronismo primario: 0,5%–2% en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la mayoría de las poblaciones:
  • Aproximadamente el 40% de los LOS Neisseria casos se deben a adenomas productores de aldosterona
  • Aproximadamente el 60% de los LOS Neisseria casos se deben a una hiperplasia suprarrenal bilateral
  • Otras causas son raras
• Prevalencia del hiperaldosteronismo secundario: desconocida
• Asociación del hiperaldosteronismo primario con la hipertensión:
  • Se encuentra en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el 10% de los LOS Neisseria pacientes con hipertensión
  • La causa más común de hipertensión, que se debe a una endocrinopatía
• Normalmente, se diagnostica en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum adultos; es raro en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum niños

Etiología

Fisiopatología

La función principal de la aldosterona es aumentar la presión arterial, que ocurre por un aumento del sodio y, por tanto, una mayor reabsorción de agua por parte de los LOS Neisseria riñones, al AL Amyloidosis tiempo que se excretan iones de potasio e hidrógeno.

Revisión de fisiología

• La síntesis de aldosterona es estimulada directamente por:
  • Angiotensina II
  • Hiperpotasemia
• Eje SRAA:
  • La renina (secretada por las células yuxtaglomerulares dentro de los LOS Neisseria riñones) → convierte el angiotensinógeno (secretado por los LOS Neisseria hepatocitos) en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum angiotensina I
  • La ECA (secretada por el endotelio vascular pulmonar) → convierte la angiotensina I en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum angiotensina II
  • La angiotensina II → estimula la liberación de aldosterona (secretada por la zona glomerulosa Zona Glomerulosa The narrow subcapsular outer zone of the adrenal cortex. This zone produces a series of enzymes that convert pregnenolone to aldosterone. The final steps involve three successive oxidations by cytochrome p-450 cyp11b2. Adrenal Glands: Anatomy en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la corteza suprarrenal)
• Factores que normalmente activan el eje SRAA (y, por tanto, ↑ la aldosterona):
  • ↓ Perfusión renal:
    • ↓ Presión arterial
    • ↓ Volumen sanguíneo efectivo
  • ↓ Suministro de sodio al AL Amyloidosis riñón
  • ↑ Tono simpático
• Efectos de la aldosterona:
  • Estimula la producción de las siguientes proteínas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las células principales de los LOS Neisseria túbulos renales distales:
    • Na⁺/K⁺ ATPasa en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el lado basolateral
    • Canal de sodio epitelial ( ENaC ENaC Sodium channels found on salt-reabsorbing epithelial cells that line the distal nephron; the distal colon; salivary ducts; sweat glands; and the lung. They are amiloride-sensitive and play a critical role in the control of sodium balance, blood volume, and blood pressure. Liddle Syndrome, por sus siglas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum inglés) en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el lado de la luz: permite la reabsorción de Na⁺ desde el lumen hacia las células principales
    • Canal de potasio medular externo renal (ROMK, por sus siglas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum inglés) en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el lado de la luz: permite la excreción de K⁺ en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la orina
  • Estimula la reabsorción de Na⁺ en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria túbulos renales:
    • El agua sigue al AL Amyloidosis Na⁺.
    • Crea un gradiente eléctrico negativo a través del lumen promoviendo la secreción de K⁺ y H⁺ en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la orina
• Resultado final de ↑ aldosterona:
  • ↑ Presión arterial (↑ reabsorción de agua por los LOS Neisseria riñones)
  • ↑ Na⁺ sérico (↓ excreción urinaria de Na⁺)
  • ↓ K⁺ sérico (↑ excreción urinaria de K⁺)
  • ↑ pH pH The quantitative measurement of the acidity or basicity of a solution. Acid-Base Balance sérico (↑ excreción urinaria de H⁺)

Hiperaldosteronismo primario

• Secreción no regulada (autónoma) de aldosterona:
  • Hipertensión secundaria
  • Hipopotasemia
  • Alcalosis metabólica
• Conduce a una compensación ↓ en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la renina
• Mecanismo de escape de la aldosterona:
  • El cuerpo percibe el volumen de sangre ↑ e intenta corregirlo
  • Secreción de péptido natriurético auricular (ANP, por sus siglas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum inglés) → diuresis
  • El resultado es que el edema Edema Edema is a condition in which excess serous fluid accumulates in the body cavity or interstitial space of connective tissues. Edema is a symptom observed in several medical conditions. It can be categorized into 2 types, namely, peripheral (in the extremities) and internal (in an organ or body cavity). Edema no suele estar presente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el hiperaldosteronismo primario.

Hiperaldosteronismo secundario

• ↓ Flujo sanguíneo renal debido a otras enfermedades
• Conduce a una compensación ↑ en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum renina → ↑ aldosterona:
  • Hipertensión secundaria
  • Hipopotasemia
  • Hipernatremia
  • Alcalosis metabólica
• ↑ La reabsorción de Na⁺ y agua se produce por mecanismos regulados → no hay escape de aldosterona → edema Edema Edema is a condition in which excess serous fluid accumulates in the body cavity or interstitial space of connective tissues. Edema is a symptom observed in several medical conditions. It can be categorized into 2 types, namely, peripheral (in the extremities) and internal (in an organ or body cavity). Edema con fóvea

Presentación Clínica

• Hipertensión resistente al AL Amyloidosis tratamiento:
  • Cefaleas
  • Fatiga
  • Discapacidad visual
• Hipopotasemia:
  • Se encuentra en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum aproximadamente 10%‒35% de los LOS Neisseria pacientes con hiperaldosteronismo primario
  • Puede presentarse como:
    • Arritmias cardíacas
    • Debilidad muscular
    • ↓ Reflejos tendinosos profundos
    • Síntomas gastrointestinales (e.g., estreñimiento)
• Alcalosis metabólica
• Hallazgos de exámenes adicionales en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el hiperaldosteronismo secundario:
  • Edema Edema Edema is a condition in which excess serous fluid accumulates in the body cavity or interstitial space of connective tissues. Edema is a symptom observed in several medical conditions. It can be categorized into 2 types, namely, peripheral (in the extremities) and internal (in an organ or body cavity). Edema con fóvea
  • Signos/síntomas consistentes con la etiología subyacente:
    • Murmullos abdominales (estenosis de la arteria renal)
    • Hallazgos cardíacos
    • Signos de enfermedad hepática grave

Diagnóstico

Los LOS Neisseria diagnósticos de hiperaldosteronismo primario y secundario se realizan a partir de pruebas bioquímicas. La imagenología es necesaria para identificar la etiología en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria casos de hiperaldosteronismo primario.

Pruebas bioquímicas

• Quién debe hacerse la prueba:
  • Todos los LOS Neisseria pacientes con hipertensión e hipopotasemia
  • Pacientes con hipertensión resistente a los LOS Neisseria medicamentos
  • Individuos con hipertensión con una masa suprarrenal descubierta incidentalmente
  • Personas con hipertensión y fibrilación auricular
  • Todos los LOS Neisseria familiares de 1er grado de pacientes con hiperaldosteronismo primario
• Pruebas séricas de cribado de 1ra línea:
  • Concentración de aldosterona en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum plasma Plasma The residual portion of blood that is left after removal of blood cells by centrifugation without prior blood coagulation. Transfusion Products: ↑ (> 15 ng/dL) en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el hiperaldosteronismo en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum general.
  • Actividad de la renina plasmática:
    • ↓ En EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el hiperaldosteronismo primario
    • ↑ En EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el hiperaldosteronismo secundario
  • Relación aldosterona-renina: ↑ concentración de aldosterona en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum plasma Plasma The residual portion of blood that is left after removal of blood cells by centrifugation without prior blood coagulation. Transfusion Products/actividad de la renina plasmática (> 20–30) en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el hiperaldosteronismo primario.
  • Resumen:
    • Hiperaldosteronismo primario: ↑ concentración de aldosterona en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum plasma Plasma The residual portion of blood that is left after removal of blood cells by centrifugation without prior blood coagulation. Transfusion Products, ↓ actividad de la renina plasmática, ↑ relación concentración de aldosterona en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum plasma Plasma The residual portion of blood that is left after removal of blood cells by centrifugation without prior blood coagulation. Transfusion Products/ actividad de renina plasmática
    • Hiperaldosteronismo secundario: ↑ concentración de aldosterona en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum plasma Plasma The residual portion of blood that is left after removal of blood cells by centrifugation without prior blood coagulation. Transfusion Products, ↑ actividad de la renina plasmática
• Pruebas de confirmatorias:
  • Evaluar la respuesta del paciente a una carga de sal (que normalmente debería suprimir la secreción de aldosterona a medida que el cuerpo intenta eliminar el exceso de Na⁺ y agua):
    • Aldosterona en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum orina de 24 horas no suprimida tras una carga de sal oral
    • Concentración de aldosterona en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum plasma Plasma The residual portion of blood that is left after removal of blood cells by centrifugation without prior blood coagulation. Transfusion Products no suprimido tras infusión salina intravenosa
  • Muestreo de la vena suprarrenal:
    • Procedimiento radiológico de intervención utilizado para medir la aldosterona en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la sangre venosa suprarrenal
    • Se realiza para determinar si un adenoma es funcional (e.g., secreta aldosterona) antes de la escisión quirúrgica
    • Busque un aumento de 5 veces la concentración de aldosterona en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum plasma Plasma The residual portion of blood that is left after removal of blood cells by centrifugation without prior blood coagulation. Transfusion Products en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el lado del adenoma.
    • Procedimiento técnicamente exigente

Imagenología

El diagnóstico por imagenología se utiliza para diferenciar un adenoma suprarrenal unilateral de una hiperplasia suprarrenal bilateral una vez que se ha HA Hemolytic anemia (HA) is the term given to a large group of anemias that are caused by the premature destruction/hemolysis of circulating red blood cells (RBCs). Hemolysis can occur within (intravascular hemolysis) or outside the blood vessels (extravascular hemolysis). Hemolytic Anemia realizado el diagnóstico bioquímico de hiperaldosteronismo primario.

• TC de la glándula suprarrenal:
  • Prueba de elección debido a una eficacia similar a la de la RM, pero con un coste menor
  • Puede diferenciar entre:
    • Adenoma: masa solitaria hipodensa unilateral con morfología contralateral normal
    • Carcinoma: masa unilateral > 4 cm
    • Hiperplasia bilateral: engrosamiento bilateral de la glándula o cambios micronodulares
• RM de la glándula suprarrenal (raramente necesaria)

Tratamiento

Tratamiento médico

• Antagonistas de los LOS Neisseria receptores de aldosterona:
  • Opciones:
    • Espironolactona
    • Eplerenona
  • Indicado en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum:
    • Hiperplasia suprarrenal bilateral
    • Pretratamiento para pacientes quirúrgicos
• Tratamiento de la hipertensión
• Controlar y tratar los LOS Neisseria niveles de sodio y potasio:
  • Restricción de sal
  • Repleción de potasio
• Optimizar el tratamiento de las etiologías subyacentes en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el hiperaldosteronismo secundario (e.g., insuficiencia cardíaca, cirrosis)

Tratamiento quirúrgico

• Extirpar cualquier tumor Tumor Inflammation que segregue hormonas (adrenalectomía).
• Indicado en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum fuentes unilaterales:
  • Adenomas suprarrenales
  • Carcinoma suprarrenal

Complicaciones

• Complicaciones cardiovasculares debidas a la hipertensión:
  • Hipertrofia
  • Dilatación
  • IM
  • Eventos cerebrovasculares
  • Enfermedad arterial periférica
• Enfermedad renal por hipertensión:
  • Esclerosis renal
  • Insuficiencia renal
• Deterioro de la secreción de insulina debido a la hipopotasemia crónica → diabetes Diabetes Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycemia and dysfunction of the regulation of glucose metabolism by insulin. Type 1 DM is diagnosed mostly in children and young adults as the result of autoimmune destruction of β cells in the pancreas and the resulting lack of insulin. Type 2 DM has a significant association with obesity and is characterized by insulin resistance. Diabetes Mellitus mellitus

Relevancia Clínica

• Hipertensión primaria: elevación de la presión arterial que no es resultado de una respuesta fisiológica adecuada a los LOS Neisseria mecanismos de regulación. Aunque es muy común, la patogénesis sigue siendo poco conocida y es probablemente multifactorial. Deben excluirse las causas de la hipertensión secundaria. Las complicaciones incluyen enfermedades cardiovasculares y renales. El tratamiento incluye modificaciones en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el estilo de vida y tratamiento con medicamentos antihipertensivos.
• Otras causas de hipertensión secundaria: Existen otras condiciones que pueden provocar un aumento de la presión arterial, como el uso de medicamentos, la enfermedad renal primaria, la apnea obstructiva del sueño, el feocromocitoma, el síndrome de Cushing y la coartación de la aorta Aorta The main trunk of the systemic arteries. Mediastinum and Great Vessels: Anatomy. Los LOS Neisseria signos y síntomas que sugieren estas condiciones deben hacer que se realicen las pruebas adecuadas.
• Hipopotasemia por otras causas: definida como niveles de potasio en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum plasma Plasma The residual portion of blood that is left after removal of blood cells by centrifugation without prior blood coagulation. Transfusion Products < 3,5 mEq/L. La hipopotasemia puede ser el resultado de la pérdida de potasio debida a la acidosis Acidosis A pathologic condition of acid accumulation or depletion of base in the body. The two main types are respiratory acidosis and metabolic acidosis, due to metabolic acid build up. Respiratory Acidosis tubular renal, las nefropatías con pérdida de sal (e.g., los LOS Neisseria síndromes de Bartter y Gitelman), el aumento del cortisol Cortisol Glucocorticoids y los LOS Neisseria aniones no reabsorbibles. Otras causas de hipopotasemia son las pérdidas gastrointestinales, los LOS Neisseria desplazamientos transcelulares, la ingesta dietética deficiente y la hipomagnesemia. El diagnóstico se ve VE Ventilation: Mechanics of Breathing favorecido por la evaluación del estado del pH pH The quantitative measurement of the acidity or basicity of a solution. Acid-Base Balance, la presión arterial y los LOS Neisseria niveles de magnesio. El tratamiento implica la sustitución del déficit de potasio y el tratamiento de la causa subyacente.