Hyponatremia in a patient with scleroderma renal crisis: a potential role of activated renin-angiotensin system

BMC Nephrology

Table 1 Levels of serum sodium, RAS components and ADH at the time of and after admission

	On admission	Day 8 (1st)	Day 40 (2nd)	Day 60 (3rd)	Day 110
Medication		Enalapril	Candesartan 4 mg	Candesartan 8 mg	Candesartan 12 mg + Aliskiren
Sodium (mEq/L)	131	116	120	124	136
Renin (0.3-2.9 ng/ml/hr)	> 20	> 20	> 20	> 20	2.2
Angiotensin I (< 110 pg/ml)	210	1100	350	560	< 30
Angiotensin II (< 22 pg/ml)	330	41	1500	1100	27
Aldosterone (2.9-15.9 ng/dl)	18.5	14.0	14.0	7.87	3.87
ADH (pg/ml)	Not determined	6.1	0.9	1.0	Not determined
Serum creatinine (mg/dl)	4.69	5.03	5.58	6.06	6.04
Body weight (kg)	Not determined	49.1	46.9	48.1	46.1

Definition of the abbreviations: RAS, renin-angiotensin system, ADH, antidiuretic hormone, Renin, plasma renin activity. Numerical values in each parenthesis indicate normal values.
Note: Conversion factors for units: plasma renin activity in ng/ml/hr to ng/L/s, x 0.2778; angiotensin I in pg/ml to fmol/ml, x 0.772; angiotensin II in pg/ml to fmol/ml, x 0.956; aldosterone in ng/dl to nmol/L, x 0.02774; ADH in pg/ml to pmol/L, x 0.923; serum creatinine in mg/dl to mmol/L, x 88.4. No conversion is necessary for serum sodium in mEq/L and mmol/L.

ISSN: 1471-2369