Primary aldosteronism

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See also aldosteronism

  1. Due to an adenoma of the glomerulosa cells of the adrenal cortex or rarely to an adrenal carcinoma or hyperplasia
  2. Hypersecretion of aldosterone results in hypernatremia, hyperchloremia, hypervolemia, and hypokalemic alkalosis with weakness, paresthesias, transient paralysis and tetany
    1. patients may also have increased diastolic blood pressure and polyuria
  3. Diagnosis: spironolactone which reverses the symptoms of the disease in several weeks; another useful test is to measure renin secretion after giving lasix – normal people have big increase in renin while those with hyperaldosteronism do not
  4. Treatment: removal of the adenoma or spironolactone
  5. Secondary aldosteronism is probably due to renin hypersecretion secondary to renal vasoconstriction (e.g. cardiac failure, cirrhosis, nephritic syndrome); seen in hypertension due to obstructive renal artery disease and hypovolemic states
  6. Compare with Addison’s disease which is a hypoaldosterone state and can lead to metabolic acidosis (normal anion gap)
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