Effect of mineralocorticoids on the paradoxical glucose-induced hyperkalemia in nondiabetic patients with selective hypoaldosteronism.

Intravenous infusion of hypertonic glucose induced a transitory paradoxical serum potassium elevation in 3 nondiabetic patients with selective hypoaldosteronism. The abnormal serum potassium response developed in spite of a normal insulin release and was abolished by pharmacological doses of mineralocorticoids in two. It is apparent that in certain patients with aldosterone deficiency normal insulin production alone cannot reverse completely the hyperosmolality-induced transfer of potassium from the intracellular to the extracellular fluid.