Hyperaldosteronism Flashcards
What is hyperaldosteronism?
clinical manifestations of excess aldosterone production
What are primary causes of hyperaldosteronism?
- adrenal adenoma (Conn’s)
- bilateral adrenal hyperplasia
- adrenal carcinoma (rare)
What are secondary causes of hyperaldosteronism?
anything driving excess activation of RAAS
When is renin produced?
- in response to stimulation from JG cells in the kidney
2. detects circulating blood volume and sodium levels
What does renin act on?
angiotensinogen and it is converted to AT 1 then ACE from the lungs converts AT 1 to AT II
What does AT II do?
is the signal that drives aldosterone production in the adrenals
What does the high aldosterone do?
exhibits negative feedback on the RAAS so renin would be low
What syndromes can cause secondary hyperaldosteronism?
- renin secreting tumours
- renal artery stenosis
- genetic syndromes
- physiological state of hypovolaemia
What is the presentation of hyperaldosteronism?
- Hypertension in young person
2. Hypokalamia
What would the hyperaldosteronism symptoms be in young person (hypertension)?
- headach
- visual changes
- SOB
- CP
• Often refractory to treatment
What are symptoms of hypokalamia?
- cardiac arrhythmias
- polyuria
- polydipsia
- muscle weakness
What are Conn’s syndrome features?
- High aldosterone
- High BP
- Low blood K+
- Polyuria
- Fatigue
What investigations are done for hyperaldosteronism?
- Blood pressure
- Bloods
• Sodium
• Potassium - Aldosterone : renin ratio (screening for primary causes)
- Further adrenal imaging
What is the management for an adrenal adenoma (Conn’s)?
spironolactone (aldosterone antagonist)
What is the management for bilateral adrenal hyperplasia?
aldosterone antagonists – spironolactone
