hyperaldosteronism Flashcards
define hyperaldosteronism
Excess aldosterone production from the adrenal gland or due to excess Renin release.
what are the primary causes of Hyperaldosteronism?
– Intrinsic pathology of adrenal cortex - excess production of aldosterone from the zona glomerulosa.
-Most commonly due to Conn’s syndrome – tumour of the adrenal gland
-Bilateral adrenal hyperplasia
what are the secondary causes of Hyperaldosteronism?
Excessive activation of the RAAS which results in excess aldosterone (ie cause does not originate from adrenal cortex)
what does aldosterone do?
Aldosterone increases Na+ and H2O reabsorption but increases K+ and H+ excretion from the DCT and CD
how does aldosterone increase reabsorption/ excretion ?
This is done through the activation of ENaC, Na+/H+ antiporter and increased Na+/K+ ATPase activity.
what are the secondary Hyperaldosteronism causes?
Examples of underlying causes of excess RAAS activation:
-Excessive diuretic therapy (most common)
-Renal artery stenosis
-Cirrhosis w ascites
-Congestive Heart Failure
-Nephritic syndrome
what are the signs of hyperaldosteronism?
Triad of:
-Alkalosis (due to loss of H+)
-Hypertension
-Hypokalaemia
what are the symptoms of hyperaldosteronism?
-Polydipsia
-Muscle weakness and spasms (due to hypokalaemia)
-Fatigue
-Headache
what is the epidemiology for hyperaldodteronism?
More frequent in females (both primary and secondary)
Seen in ~10% hypertensive patients
Primary is more commonly diagnosed than secondary
what is the treatment/ management for hyperaldosteronism?- primary
–Primary
Surgery is the preferred choice
Mineralocorticoid receptor antagonist (MRA)
Spironolactone
Eplerenone
what is the treatment/ management for hyperaldosteronism?- secondary
Treat underlying disease
what should you limit with hyperaldosteronism?
limit salt intake
how do you diagnose hyperaldosteronism?
- Blood test
- CT
- Adrenal vein sampling
- Renal Artery sampling
- Aldosterone- Renin ratio **
what does the Aldosterone- Renin ratio tell you in hyperaldosteronism?
this is used to tell you whether or not it is Primary or Secondary.
-High Aldosterone and Low Renin is Primary.
- High Aldosterone and High Renin is Secondary.
why do you do a U&Es blood test for hyperaldosteronism ?
to look for K+ for hypokalaemia
