Hyporeninemic hypoaldosteronism and diabetes mellitus: Pathophysiology assumptions, clinical aspects and implications for management

Figure 1 Pathophysiology of hyporeninemic hypoaldosteronism related to diabetes mellitus. ANP: Atrial natriuretic peptide; K⁺: Potassium.

Figure 2 Diagnosis and management of hyporeninemic hypoaldosteronism related to diabetes mellitus. ¹In any cases, it might be necessary to activate the renin-angiotensin-aldosterone system (using a loop diuretic or the upright position); ²After using diuretics, the use of ACEIs or ARBs should be restarted (if suspended). ACEIs: Angiotensinogen-converting enzyme inhibitors; Aldo: Aldosterone; ARBs: Angiotensin receptor blockers; CER: Calcium exchange resins; HyperK⁺: Hyperkalemia; K⁺: Potassium; PRA: Plasma renin activity; HH: Hyporeninemic hypoaldosteronism.