Case Report: Adrenalectomy for Primary Hyperaldosteronism; Not the Final Step

Abstract Background: Aldosterone-induced glomerular hyper-filtration leads to masked renal dysfunction and profound hypokalemia which will affect the outcome post adrenalectomy. Description of the case: We report a case of a middle-aged man presenting for Primary Aldosteronism, managed by unilateral adrenalectomy, complicated by acute kidney injury and hyperkalemia, treated initially by intravenous hydration and then by Fludrocortisone as maintenance therapy. Patient has noticeably improved. Conclusion: Post-adrenalectomy, the association of acute kidney injury and hyperkalemia in patients with PA is not rare but underestimated. Serum potassium and creatinine must be cautiously monitored in patients with long-term hypertension and kidney disease.