A 28-Year-Old Male Presents with Polyuria and Polydipsia

A 28-year-old male presents with polyuria and polydipsia.  Lately, he has been getting up at least six times  during the night to urinate.  He denies any past medical problems.  He is currently on no medications.  His family history is unremarkable.  He migrated from India four years ago.  He chews tobacco, but does not smoke.  He denies alcohol use.  Physical examination reveals a blood pressure of 160/94 mmHg.  He weighs 165 pounds and is 5' 7" tall.  The thyroid gland is normal to palpation.  There is no abdominal bruit.  The rest of the physical examination is unremarkable.  His potassium level is 3.2 mEq/L.  Hypokalemia is confirmed on repeat testing.  What is the next best step in the evaluation of this patient?

A) 24-hour urinary cortisol levels
B) Plasma aldosterone to renin ratio
C) Deoxycorticosterone levels
D) MR angiography of the renal arteries
E) 24-hour urinary potassium levels

Correct Answer:

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