03 November 2024
: Case report 
Finerenone as a Novel Treatment for Gitelman Syndrome: A Case Study of a 35-Year-Old Male with Adrenal Mass and Hypokalemia
Challenging differential diagnosis, Rare disease, Adverse events of drug therapy
Rujie Jiang1ABCDEF, Qiue Liu1B, Yanan Sun1B, Xiaoqing Dai1C, Feng Xu1D*, Fang Wang1ADEFDOI: 10.12659/AJCR.944492
Am J Case Rep 2024; 25:e944492
Table 5. Recommended methods, mechanism, adverse effects, and applications.
| Treatment methods | Mechanism | Adverse effects | Applications | |
|---|---|---|---|---|
| Potassium supplements | Supplement potassium ions to correct hypokalemia | Gastrointestinal discomfort, hyperkalemia (if overdosed) | Not effective when used alone | |
| Magnesium supplements | Supplement magnesium ions to correct. hypomagnesemia | Diarrhea (if oral dose is too high), hypermagnesemia (if overdosed), which can lead to muscle weakness and low blood pressure | Not effective when used alone | |
| Potassium-sparing diuretics | Competitively inhibit aldosterone receptors or directly inhibit sodium channels in the distal tubule and collecting duct of the kidney, reducing potassium excretion | Spironolactone | Hormonal adverse effects | Discontinued due to adverse effects |
| Eplerenone | Hypotension | Unavailable | ||
| Finerenone | Hyperkalemia | Currently in use | ||
| ACEI/ARB | Lower levels of angiotensin II and aldosterone, reducing sodium reabsorption and potassium excretion | Dry cough (ACEI), hyperkalemia, hypotension, acute kidney injury, allergy | Unconventional treatment with significant adverse effects | |
| NSAIDs | Inhibit cyclooxygenase (COX) to reduce prostaglandin production, thereby decreasing potassium excretion in renal tubular epithelial cells | Gastrointestinal ulcers, bleeding, renal function impairment | ||
| ACEI – angiotensin-converting enzyme inhibitors; ARB – angiotensin receptor blocker; NSAIDs – non-steroidal anti-inflammatory drugs. | ||||