In primary adrenal insufficiency, which electrolytes are commonly disturbed?

• A. Hyperkalemia and hyponatremia
• B. Hypokalemia and hypernatremia
• C. Hypercalcemia and hypophosphatemia
• D. Hypomagnesemia and hyperkalemia

Answer: (A)

In primary adrenal insufficiency, lack of aldosterone causes the kidneys to waste salt and retain potassium. That combination leads to hyponatremia (low sodium) and hyperkalemia (high potassium), which is the classic electrolyte disturbance in this condition. The decreased aldosterone normally promotes sodium reabsorption and potassium excretion, so its deficiency produces the opposite effect. Other electrolyte patterns—like low potassium with high sodium, or abnormalities in calcium, phosphate, or magnesium—don’t reflect this aldosterone-driven imbalance as consistently.