hyperaldosteronism

Question 1

what is Conn’s syndrome

Answer 1

adrenal adenoma producing too much aldosterone

Question 2

what is aldosterone

Answer 2

mineralocorticoid steroid hormone
acts on the nephrons in the kidneys to:
- increase sodium reabsorption from distal tubule
- increase potassium secretion from distal tubule
- increase hydrogen secretion from collecting ducts

Question 3

what is primary hyperaldosteronism

Answer 3

the adrenal glands are directly responsible for producing too much aldosterone
serum renin low

Question 4

causes of primary hyperaldosteronism

Answer 4

bilateral adrenal hyperplasia (most common)
adrenal adenoma (Conn’s)
familial hyperaldosteronism

Question 5

causes of secondary hyperaldosteronism

Answer 5

excessive renin stimualting the release of excessive aldosterone
renal artery stenosis
heart failure
liver cirrhosis and ascites

Question 6

investigations for hyperaldosteronism

Answer 6

aldosterone-to-renin ration (ARR)
- high aldosterone to low renin= primary
- high aldosterone to high renin= secondary

raised blood pressure
low potassium
ABG: alkalosis

CT or MRI to look for adrenal tumour or hyperplasia
renal artery imagining (doppler, CY angiogram, MR angiography)
adrenal vein sampling

Question 7

management of hyperaldosteronism

Answer 7

medical: aldosterone antagonists
- eplerenone or spironolactone

surgical removal of adrenal adenoma
percutaneous renal artery angioplasty