Endocrine and hypertensive disorders of potassium regulation: primary aldosteronism.

Abstract

The identification of primary aldosteronism as a common cause of resistant hypertension is a significant advance in our ability to care for patients with hypertension. Primary aldosteronism is common, and when unrecognized is associated with an increased incidence of adverse cardiovascular outcomes. Identification of primary aldosteronism is based on use of the plasma aldosterone level, plasma renin activity, and the aldosterone:renin ratio. Differentiation between unilateral and bilateral autonomous adrenal aldosterone production then guides further therapy, with use of mineralocorticoid-receptor blockers for patients with bilateral autonomous adrenal aldosterone production and laparoscopic adrenalectomy for patients with unilateral autonomous aldosterone production. In this review, we discuss in detail the pathogenesis of primary aldosteronism-induced hypertension and potassium disorders, the evaluation of the patient with suspected primary aldosteronism, and the management of primary aldosteronism, both through medications and surgery.

• Authors: I David Weiner
• Journal: Seminars in nephrology (Semin Nephrol) Vol. 33 Issue 3 Pg. 265-76 (May 2013) ISSN: 1558-4488 [Electronic] United States
• PMID: 23953804 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, U.S. Gov't, Non-P.H.S., Review)
• Copyright: Published by Elsevier Inc.

Chemical References

• Mineralocorticoid Receptor Antagonists
• Spironolactone
• Aldosterone
• Eplerenone
• Renin

Topics

• Adrenal Cortex Neoplasms (complications, surgery)
• Adrenalectomy
• Adrenocortical Adenoma (complications, surgery)
• Aldosterone (blood)
• Eplerenone
• Humans
• Hyperaldosteronism (complications, diagnosis, therapy)
• Hypertension (diagnosis, etiology, therapy)
• Hypokalemia (diagnosis, etiology, therapy)
• Mineralocorticoid Receptor Antagonists (therapeutic use)
• Renin (blood, physiology)
• Spironolactone (analogs & derivatives, therapeutic use)