What electrolyte abnormality is commonly seen with hypoaldosteronism?

• A. Hypokalemia and hypernatremia
• B. Hyperkalemia and hyponatremia; mild metabolic acidosis
• C. Hypernatremia and hypochloremia
• D. Normal electrolytes

Answer: (B)

Low aldosterone reduces Na reabsorption and the secretion of K+ and H+ in the distal nephron. With hypoaldosteronism, sodium is lost in the urine (hyponatremia) and potassium is not adequately excreted (hyperkalemia). Hydrogen ion secretion also falls, leading to a mild metabolic acidosis (often hyperchloremic). This combination—hyperkalemia, hyponatremia, and a mild metabolic acidosis—is the expected electrolyte profile in hypoaldosteronism.

The other patterns don’t fit: excessive mineralocorticoid activity would cause hypernatremia and hypokalemia; hypernatremia with hypochloremia isn’t typical for this condition; normal electrolytes wouldn’t reflect the impaired aldosterone effect.