Hyperaldosteronism (conn's) Flashcards
What is hyperaldosteronism?
High levels of aldosterone
What are the main causes of hyperaldosteronism?
Unilateral benign adrenal adenoma
Or
Bilateral adrenal hyperplasia
What is the most common cause of hyperaldosteronism?
Bilateral adrenal hyperplasia
What is another term for primary hyperaldosteronism?
Conn’s syndrome
What are the 2 main presenting features of hyperaldosteronism?
Hypokalaemia
Hypertension
Metabolic alkalosis
What is Conn’s syndrome?
An adrenal adenoma producing too much aldosterone
What symptoms can present in primary aldosteronism due to hypertension?
Headaches and retinopathy
What symptoms can present in primary hyperaldosteronism due to hypokalaemia?
Paraesthesia
Muscle weakness
Cardiac arrhythmias
What does an excess of aldosterone cause?
Excessive aldosterone production causes
-Renal sodium retention
which is balanced by the loss of potassium and hydrogen ions in the distal convoluted tubule of the kidney.
What type of hormone is aldosterone?
Mineralocorticoid steroid hormone
What are the mian investigations for primary hyperaldosteronism?
- plasma aldosterone
- U&Es
- High resolution CT abdomen
- adrenal venous sampling
What would you see with plasma aldosterone: renin ratio in someone with hyperaldosteronism?
High aldosterone and low renin levels
What might you find in the U&E’s of someone with hyperaldosteronism?
Hyperkalaemia
Why might you do a CT abdomen in someone with hyperaldosteronism?
To differentiate between adrenal adenoma or bilateral adrenal hyperplasia
What is the function of adrenal venous sampling in someone with hyperaldosteronism?
Confirms if a unilateral adrenal adenoma is responsible for excess production of aldosterone
What is the management if the adrenal adenoma is causing the hyperaldosteronism?
Surgery- unilateral adrenalectomy
What is the management if it is bilateral adrenal hyperplasia is causing the hyperaldosteronism?
Aldosterone antagonist- spironolactone
What effect does aldosterone have on the nephrons of the kidneys in someone with hyperaldosteronism?
Increase sodium reabsorption from the distal tubule
Increase potassium secretion from the distal tubule
Increase hydrogen secretion from the collecting ducts
What is secondary hyperaldosteronism caused by?
Excessive renin stimulating the release of excessive aldosterone.
What causes the release of excessive renin?
Disproportionately lower blood pressure in the kidneys
What is the low blood pressure in the kidneys usually due to?
Renal artery stenosis
Heart failure
Liver cirrhosis and ascites
What aldosterone: renin ration would indicate secondary hyperaldosteronism?
High aldosterone and high renin indicate secondary hyperaldosteronism
What could be used in the management of renal artery stenosis?
Percutaneous renal artery angioplasty via the femoral artery to treat renal artery stenosis
