Hyperkalemic distal renal tubular acidosis and selective aldosterone deficiency. Combination in a patient with lead nephropathy.

A patient with chronic renal failure, a strong history of moonshine abuse, and excessive urinary lead excretion had clinical and laboratory measurements compatible with combined hyperkalemic distal renal tubular acidosis and the syndrome of selective aldosterone deficiency. Extended treatment with fludrocortisone acetate, 0.1 to 0.2 mg/day, did not ameliorate acidosis or restore potassium excretion.