Adrenal: Hyperaldosteronism Flashcards
(24 cards)
What is Hyperaldosteronism?
HIGH levels of ALDOSTERONE
Hyperaldosteronism is a condition characterized by excessive production of aldosterone, leading to various physiological effects.
What condition is associated with adrenal adenoma producing too much aldosterone?
Conn’s syndrome
Conn’s syndrome is a specific type of primary hyperaldosteronism.
What is the most common cause of secondary hypertension?
Hyperaldosteronism
Hyperaldosteronism can lead to elevated blood pressure, making it a frequent cause of secondary hypertension.
What are the common symptoms of Hyperaldosteronism?
HYPERTENSION, headaches, muscle weakness, fatigue
Symptoms are often vague, and some patients may be asymptomatic.
What role does Aldosterone play in the body?
- Increases Na+ absorption in the distal tubule (retains water too)
Increases K+ secretion from the distal tubule - Increases H+ secretion from the collecting duct
–> Vasoconstriction of vessles
–> AIM” Increase BP
Aldosterone is a key hormone in regulating blood pressure and fluid balance.
What triggers the release of Renin?
Low Na+, Low volume, Low arterial pressure
Renin is released in response to low blood pressure or low sodium levels, activating the RAAS.
What is Primary Hyperaldosteronism?
Adrenal gland responsible for EXCESS aldosterone
In primary hyperaldosteronism, the adrenal gland secretes too much aldosterone, leading to water retention without sodium changes.
What are the laboratory findings in Primary Hyperaldosteronism?
- Serum renin LOW
- High BP + hypernatraemia
- Hypokalaemia
The low renin level is due to suppression from high blood pressure.
What are soem common causes of primary hyperaldoesteronism?
Bilateral adrenal hyperplasia, adrenal adenoma secreting aldosterone (Conn’s syndrome), familial hyperaldosteronism.
What is Secondary Hyperaldosteronism?
Excessive renin stimulating excess aldosterone release
Secondary hyperaldosteronism is usually due to conditions that cause low blood flow to the kidneys.
What are the laboratory findings in Secondary Hyperaldosteronism?
HIGH renin
High renin levels are observed because the** kidneys perceive low blood pressure.**
Common cause of secondary hyperaldosteronism
Renal artery stenosis, heart failure, liver cirrhosis and ascites
What are common symptoms of Hyperaldosteronism?
Weakness, fatigue, polyuria
Symptoms are often non-specific and can overlap with other conditions.
What signs are associated with Hyperaldosteronism due to hypertension and fluid retention?
End organ damage, ECG abnormalities (arrythmias)
Severe: oedema, raised JVP, hypertrophic heart, stoke
Long-term hypertension can lead to complications affecting multiple organ systems.
What is the initial screening test for Hyperaldosteronism?
Aldosterone-to-renin ratio (ARR)
This test helps differentiate between primary and secondary hyperaldosteronism.
What dietary/health conditions must be met for the ARR test?
- Normal (non-low salt diet)
- Review medicication as some may have side effects that effect the test
A low salt diet can artificially lower aldosterone levels, affecting test accuracy.
What indicates Primary Hyperaldosteronism in the ARR test results?
High aldosterone + low renin
This combination suggests that aldosterone is being produced independently of renin.
What indicates Secondary Hyperaldosteronism in the ARR test results?
High aldosterone + high renin
This suggests that aldosterone release is a response to stimulated renin due to perceived low blood pressure.
What additional markers are looked for in Hyperaldosteronism?
- Raised Blood Pressure
- Hypokalaemia
- Blood gas analysis - alkalosis (aldosterone causes K+ secretion which travels with H+ causing an acid loss leading to alkalosis
These markers help confirm the diagnosis and assess the impact of aldosterone on the body.
What imaging techniques are used for further investigation in Hyperaldosteronism?
CT, MRI, renal artery imaging
These imaging studies help identify adrenal tumors or renal artery stenosis.
What is the management for Hyperaldosteronism?
- Aldosterone antagonists - Eplerenone/Spironalactone
- Treat underlying cause - surgery
Treatment may involve medications like spironolactone or surgical interventions.
Name two types of aldosterone antagonists used in treatment.
Eplerenone, Spironolactone
These medications help block the effects of aldosterone and promote potassium retention.
What surgical treatment might be considered for adrenal adenoma in Hyperaldosteronism?
Surgical removal of adrenal adenoma
This is typically indicated in cases of Conn’s syndrome.
What procedure might be performed to treat renal artery stenosis?
Percutaneous renal artery angioplasty
This minimally invasive procedure can help restore blood flow to the kidneys.
