[Plasma renin activity and serum aldosterone concentration in severe handicapped patients]

Plasma renin activity (PRA) and serum aldosterone concentration (Ald) were studied in 25 severe handicaps at the rest position. Sixteen cases (64%) showed increased PRA and/or Ald. In four cases treated with acetazolamide PRA or Ald was increased. After suspending this drug in three cases both PRA and Ald decreased significantly. In patients with low-salt-diet (total Na intake; less than 2 mEq/kg/day) PRA was higher than in those with normal-salt-diet (total Na intake; greater than or equal to 2 mEq/kg/day). Alb had no difference in two groups. Urine Na and Cl secretion in patients with low-salt-diet (49.1 +/- 34.1 mEq/l, 43.5 +/- 25.1 mEq/l) were remarkably low when compared to those in patients with normal-salt-diet (113.3 +/- 71.3, 94.2 +/- 56.3). NaCl supplementation in those patients with low-salt-diet for 5 days (total Na intake; 4 mEq/kg/day) resulted in normalization of their high PRA and Ald levels. This phenomenon revealed reversible since suspending NaCl supplementation again increased PRA and Ald levels. These results suggest that both low-salt-diet and acetazolamide play important roles for renin secretion in severe handicaps.