Hypokalemic metabolic alkalosis in normotensive infants with elevated plasma renin activity and hyperaldosteronism: role of dietary chloride deficiency

The role of chloride deficiency in the generation of hypokalemic metabolic alkalosis with elevated plasma renin activity and plasma aldosterone levels, normal blood pressure, and a renal concentrating defect was studied in six infants given a soy formula that was deficient in chloride. A deceleratio...

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Bibliographic Details
Published in:Pediatrics (Evanston) 1981-03, Vol.67 (3), p.423-429
Main Authors: Roy, 3rd, S, Arant, Jr, B S
Format: Article
Language:English
Subjects:
Alkalosis - drug therapy
Alkalosis - etiology
Alkalosis - metabolism
Body Height
Body Weight
Chlorides - administration & dosage
Chlorides - analysis
Electrolytes - blood
Electrolytes - metabolism
Female
Humans
Hyperaldosteronism - etiology
Hyperaldosteronism - metabolism
Hypokalemia - etiology
Hypokalemia - metabolism
Infant
Infant Food - adverse effects
Infant Food - analysis
Infant, Newborn
Male
Nutritional Requirements
Pregnancy
Renin - biosynthesis
Renin - blood
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Summary:The role of chloride deficiency in the generation of hypokalemic metabolic alkalosis with elevated plasma renin activity and plasma aldosterone levels, normal blood pressure, and a renal concentrating defect was studied in six infants given a soy formula that was deficient in chloride. A deceleration in linear growth, weight gain, and head circumference with age and delayed neurologic development were noted in every infant during the first six months of life. Microscopic hematuria and persistent elevation of plasma creatinine were noted in four of the infants. A renal biopsy in two infants revealed no juxtaglomerular hyperplasia, but interstitial tubular calcification was observed in one, and interstitial fibrosis was found in both. The generation of the hypokalemic metabolic alkalosis in these infants was explained by the reduced intake of chloride, and the addition of chloride alone to the diet resulted in a correction of the electrolyte abnormalities and the alkalosis.
ISSN:0031-4005
1098-4275
DOI:10.1542/peds.67.3.423