Synonyms for hypoaldosteronism or Related words with hypoaldosteronism
Examples of "hypoaldosteronism"
An ACTH stimulation test for aldosterone can help in determining the cause of
, with a low aldosterone response indicating a primary
of the adrenals, while a large response indicating a secondary
Hyperaldosteronism is abnormally increased levels of aldosterone, while
is abnormally decreased levels of aldosterone.
In medicine (endocrinology),
refers to decreased levels of the hormone aldosterone.
is the condition of having lowered aldosterone without corresponding changes in cortisol. (The two hormones are both produced by the adrenals.)
Pseudohypoaldosteronism (PHA) is a condition that mimics
. However, the condition is due to a failure of "response" to aldosterone, and levels of aldosterone are actually elevated, due to a lack of feedback inhibition.
Similar to the cortisol stimulation in ACTH deficiency, the test interpreter may lack knowledge of how to properly interpret for secondary
and think a result of aldosterone doubling or more from a low base value is good.
(the syndrome caused by underproduction of aldosterone) leads to the salt-wasting state associated with Addison's disease, although classical congenital adrenal hyperplasia and other disease states may also cause this situation. Acute underproduction (hemorrhagic adrenalitis) is often lifethreatening.
Pseudohyperaldosteronism (also pseudoaldosteronism) is a medical condition that mimics hyperaldosteronism. Like hyperaldosteronism, it produces hypertension associated with low plasma renin activity, and metabolic alkalosis associated with hypokalemia. Unlike hyperaldosteronism, it involves aldosterone levels that are normal or low (
Additionally, in 1987 Poretsky was a key member of the team which described a condition called hyporeninemic
, which is characterized by deficiency of adrenal hormone aldosterone, in patients with AIDS. This discovery resulted in introduction of treatment with fludrocortisone, which proved to be extremely effective and almost immediately converted most patients with this condition from being unable to stand (because of a severe drop in blood pressure upon standing) to being mobile and more functional.
Common causes include kidney failure,
, and rhabdomyolysis. A number of medications can also cause high blood potassium including spironolactone, NSAIDs, and angiotensin converting enzyme inhibitors. The severity is divided into mild (5.5-5.9 mmol/L), moderate (6.0-6.4 mmol/L), and severe (>6.5 mmol/L). High levels can also be detected on an electrocardiogram (ECG). Pseudohyperkalemia, due to breakdown of cells during or after taking the blood sample, should be ruled out.
The aldosterone response in the ACTH stimulation test is blunted or absent in patients with primary adrenal insufficiency including Addison's disease. The base value is usually in the mid teens or less and rise to less than double the base value thus indicating primary
(sodium low, potassium and renin enzyme will be high) and is an indicator of primary adrenal insufficiency or Addison's disease.
Type 4 RTA is not actually a tubular disorder at all nor does it have a clinical syndrome similar to the other types of RTA described above. It was included in the classification of renal tubular acidoses as it is associated with a mild (normal anion gap) metabolic acidosis due to a "physiological" reduction in proximal tubular ammonium excretion (impaired ammoniagenesis), which is secondary to
, and results in a decrease in urine buffering capacity. Its cardinal feature is hyperkalemia, and measured urinary acidification is normal, hence it is often called hyperkalemic RTA or tubular hyperkalemia.
The ACTH stimulation test is occasionally used to test adrenal production of aldosterone at the same time as cortisol to also help in determining if primary (hyperreninemic) or secondary (hyporeninemic)
is present. Human ACTH has a slight stimulatory effect on aldosterone, but the amount of synthetic ACTH given in the stimulation is equivalent to more than a whole days production of natural ACTH, so the aldosterone response can be easily measured in blood serum. Same as cortisol, aldosterone should double from a respectable base value (around 20 ng/dl, must fast salt 24 hours and sit upright for blood draw) in a healthy individual.
Aldosterone response of several factors from a low base value. This factoring indicates secondary
(sodium low, potassium and renin enzyme will be low). Usually doubling to quadrupling from a low base aldosterone value is what is seen in secondary adrenal insufficiency. Decoupling of aldosterone in the ACTH stimulation test is possible (i.e. 2 ng/dl stimming to 20).
A result of doubling or more of aldosterone may help in tandem with a cortisol stimulation that doubled or more confirm a diagnosis of secondary adrenal insufficiency. In rare cases, an aldosterone stimulation which did not double, but with the presence of low potassium, low renin and low ACTH indicates atrophy of aldosterone production from the prolonged lack of renin.
Copyright © 2017