Which electrolyte pattern is typical in adrenal crisis?

Which electrolyte pattern is typical in adrenal crisis?

• A. Hypokalemia and hyponatremia
• B. Hyperkalemia and hyponatremia
• C. Hypernatremia
• D. Hyperkalemia and hypernatremia

Answer: (B)

Aldosterone deficiency in adrenal crisis disrupts how the kidneys handle sodium and potassium. Without enough mineralocorticoid activity, the kidney can’t reabsorb sodium effectively and can’t excrete potassium efficiently. The result is low sodium in the blood (hyponatremia) and high potassium (hyperkalemia), often with volume depletion from salt wasting. This combination—hyponatremia with hyperkalemia—is the typical electrolyte pattern seen in primary adrenal insufficiency presenting as an acute crisis. By contrast, secondary adrenal insufficiency often preserves aldosterone, so hyperkalemia is less likely. Hypernatremia would not fit this mechanism, and hypokalemia would opposite the expected effect of aldosterone loss.

Aldosterone deficiency in adrenal crisis disrupts how the kidneys handle sodium and potassium. Without enough mineralocorticoid activity, the kidney can’t reabsorb sodium effectively and can’t excrete potassium efficiently. The result is low sodium in the blood (hyponatremia) and high potassium (hyperkalemia), often with volume depletion from salt wasting. This combination—hyponatremia with hyperkalemia—is the typical electrolyte pattern seen in primary adrenal insufficiency presenting as an acute crisis. By contrast, secondary adrenal insufficiency often preserves aldosterone, so hyperkalemia is less likely. Hypernatremia would not fit this mechanism, and hypokalemia would opposite the expected effect of aldosterone loss.