Hyperaldosteronism Flashcards
describe renin-angiotensin system
low BP sensed by juxtaglomerular cells in afferent kidney arteriole – secretion of renin
liver secretes angiotensinogen – renin converts angiotensinogen to angiotensin I
ACE secreted by lungs converts angiotensin I to angiotensin II
Angiosin II stimulates secretion of aldosterone from adrenals
what cells secrete renin in response to what?
juxtaglomerular cells in afferent kidney arteriole in response to low BP
what does renin do
converts angiotensinogen to angiotensin I
what secretes angiotensinogen
the liver
what converts angiotensin I to angiotensin II
ACE
what does angiotensin II do
stimulates aldosterone release from adrenals
effects of aldosterone
increases sodium reabsorption
increases potassium excretion
what is primary hyperaldosteronism
adrenal glands are directly responsible for producing too much aldosterone
what is primary hyperaldosteronism known as
Conns syndrome
what is the most common cause of Conns
adrenal adenoma secreting aldosterone
what are the causes of Conns
adrenal adenoma
bilateral adrenal hyperplasia
adrenal carcinoma (rare)
familial hyperaldosteronism (rare)
what will serum renin be like in Conns syndrome
Low renin as BP is high
what is secondary hyperaldosteronism
excess renin stimulates adrenals to secrete high aldosterone
causes of secondary hyperaldosteronism
renal artery stenosis
renal artery obstruction
HF
What will serum renin levels be like in renal artery stenosis
High
screening test for hyperaldosteronism
renin/aldosterone ration
high aldosterone low renin
Conns syndrome (primary)
high aldosterone high renin
secondary hyperaldosteronism
electrolytes in hyperaldosteronism
High sodium
Low potassium
symptoms of high aldosterone
HTN polyuria polydipsia muscle weakness + cramps headaches
investigations for hyperaldosteronism
CT/MRI of adrenals
Renal angiogram for stenosis
2L saline – if aldosterone levels don’t fall by 50% then there is a primary cause
treatment of bilateral adrenal hyperplasia
spironolactone
treatment of adrenal adenoma
surgical removal
ABG result in conns
metabolic alkalosis
