Hyperaldosteronism Flashcards
What hormone activated release of aldosterone from adrenal glands?
Angiotensin II
What is aldosterone?
Mineralocorticoid steroid hormone
What is the action of aldosterone?
Increases sodium reabsorption from the distal tubule
Increases potassium secretion from the distal tubule
Increases hydrogen secretion from the collecting ducts
What does hypertension and hypokalaemia indicate?
Hyperaldosteronism
What is primary hyperaldosteronism?
Adrenal glands are directly responsible for producing too much aldosterone
What are the causes of primary hyperaldosteronism?
Bilateral adrenal hyperplasia
Conn’s syndrome- adrenal adenoma secreting aldosterone
Familial hyperaldosteronism
Adrenal carcinoma
What is secondary hyperaldosteronism?
Excessive renin stimulates adrenal glands to produce more aldosterone
What are the causes of secondary hyperaldosteronism?
High renin levels
- Renal artery stenosis
- Renal artery obstruction
- Heart failure
What is the investigation of choice for hyperaldosteronism?
PAC/PRA ratio
- Plasma aldosterone concentration
- Plasma renin activity
What does high aldosterone and low renin indicate?
Primary hyperaldosteronism
What does high aldosterone and high renin indicate?
Secondary hyperaldosteronism
What other investigations are done?
BP- hypertension
Serum electrolytes- hypokalaemia
Blood gas analysis- alkalosis
CT/MRI for adrenal adenoma
What is the management of hyperaldosteronism?
Aldosterone antagonists e.g. eplerenone, spironolactone
Surgical removal of adenoma
Percutaneous renal artery angioplasty if the cause is renal artery stenosis
