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Hypoaldosteronism

hypoaldosteronism symptoms, hypoaldosteronism
Hypoaldosteronism is an endocrinological disorder characterized decreased levels of the hormone aldosterone Similarly, isolated hypoaldosteronism is the condition of having lowered aldosterone without corresponding changes in cortisol The two hormones are both produced by the adrenals

Contents

  • 1 Causes
  • 2 Diagnosis
  • 3 Treatment
  • 4 Effects
  • 5 See also
  • 6 References

Causes

There are several causes for this condition, including adrenal insufficiency, congenital adrenal hyperplasia, and some medications such as certain diuretics, NSAIDs, and ACE inhibitors

  • Primary aldosterone deficiency
  1. Primary adrenal insufficiency
  2. Congenital adrenal hyperplasia 21 and 11β but not 17
  3. Aldosterone synthase deficiency
  • Secondary aldosterone deficiency
  1. Secondary adrenal insufficiency
  2. Diseases of the pituitary or hypothalamus
  • Hyporeninemic hypoaldosteronism due to decreased angiotensin 2 production as well as intra-adrenal dysfunction
  1. Renal dysfunction-most commonly diabetic nephropathy
  2. NSAIDs
  3. Ciclosporin

Diagnosis

Treatment

  • Aldosterone deficiency should be treated with a mineralocorticoid such as fludrocortisone, as well as possibly a glucocorticoid for cortisol deficiency, if present
  • Hyporeninemic hypoaldosteronism is amenable to fludrocortisone treatment, but the accompanying hypertension and edema can prove a problem in these patients, so often a diuretic such as the thiazide diuretic, bendrofluazide, or a loop diuretic, such as furosemide is used to control the hyperkalemia

Effects

Hypoaldosteronism may result in hyperkalemia and is the cause of 'type 4 renal tubular acidosis', sometimes referred to as hyperkalemic RTA or tubular hyperkalemia However, the acidosis, if present, is often mild It can also cause urinary sodium wasting, leading to volume depletion and hypotension

When adrenal insufficiency develops rapidly, the amount of Na+ lost from the extracellular fluid exceeds the amount excreted in the urine, indicating that Na+ also must be entering cells When the posterior pituitary is intact, salt loss exceeds water loss, and the plasma Na+ falls However, the plasma volume also is reduced, resulting in hypotension, circulatory insufficiency, and, eventually, fatal shock These changes can be prevented to a degree by increasing the dietary NaCl intake Rats survive indefinitely on extra salt alone, but in dogs and most humans, the amount of supplementary salt needed is so large that it is almost impossible to prevent eventual collapse and death unless mineralocorticoid treatment is also instituted

See also

  • Addison's disease
  • Adrenal gland
  • Hyperaldosteronism
  • Pseudohypoaldosteronism

References

  1. ^ Becker, Kenneth L 2001 Principles and practice of endocrinology and metabolism Lippincott Williams & Wilkins pp 785– ISBN 978-0-7817-1750-2 Retrieved 15 July 2011 
  2. ^ a b DeFronzo RA 1980 "Hyperkalemia and hyporeninemic hypoaldosteronism" Kidney Int 17 1: 118–34 doi:101038/ki198014 PMID 6990088 
  3. ^ Sebastian A, Schambelan M, Sutton JM 1984 "Amelioration of hyperchloremic acidosis with furosemide therapy in patients with chronic renal insufficiency and type 4 renal tubular acidosis" Am J Nephrol 4 5: 287–300 doi:101159/000166827 PMID 6524600 

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Hypoaldosteronism


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    Hypoaldosteronism beatiful post thanks!

    29.10.2014


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