Hyperaldosteronism Flashcards
1
Q
State 3 actions of aldosterone
A
- Increase ENaC in distal tubule to increase Na+ reabsorption
- Increase K+ excretion in distal tubule
- Increase H+ excretion from collecting ducts
2
Q
Describe primary hyperaldosteronism, include:
- Where excess aldosterone comes from
- Renin levles
- Causes
A
Primary Hyperaldosteronism
- Adrenal glands producing too much aldosterone
- Renin low
- Causes:
- Adrenal adenoma (Conn’s syndrome)
- Bilateral adrenal hyperplasia
- Familial hyperaldosteronism
- Adrenal carcinoma
3
Q
Describe secondary hyperaldosteronism, include:
- Where excess aldosterone comes from
- Renin levels
- Causes
A
- Excessive renin stimulating adrenal glands to produce more aldosterone
- Renin high
- Causes (anything that makes kidneys think BP is low):
- Renal artery stenosis
- Renal artery obstruction
- Heart failure
4
Q
State symptoms of hyperaldosteronism
A
- Headaches
- Lethargy
- Muscle cramps
5
Q
State what you might when doing basic observations on a pt with hyperaldosteronism
A
Hypertension
6
Q
State some investigations you might do for hyperaldosteronism, include:
- Bedside
- Bloods
- Imaging
A
Bedside
- ABG/VBG: alkalosis as aldosterone increases H+ excretion
- ECG: arrhythmias may be present due to electrolyte abnormalities e.g. hypokalaemia
Bloods
- U&Es
- Renin
- Aldosterone
Imaging
- CT/MRI : look for adrenal tumour
- Renal doppler ultrasound, CT angiogram or MRA: for renal artery stenosis or obstruction
7
Q
Discuss the management of hyperaldosteronism
A
-
Treat underlying cause:
- Conn’s: remove adenoma
- Renal artery stenosis: percutaneous renal artery angioplasty
-
Aldosterone antagonists:
- e.g. Spironolactone, eplerenone
*NOTE: if cause is bilateral adrenal hyperplasia treatmetn with aldosterone antagonists is first line
8
Q
State some complications of hyperaldosteronism
A
- Hypertension
- Alkalosis
- Hypokalaemia
9
Q
What are the biochemical hallmarks of hyperaldosteronism?
A
- Hypernatraemia
- Hypokalaemia
- Alkalosis
