Hiperaldosteronismo e hipoaldosteronismo

  1. I.A. Rodríguez-Gómez 1
  2. I. Bernabeu 2
  3. C. Guillín 2
  4. F.F. Casanueva 2
  1. 1 Unidad de Endocrinología y Nutrición. Hospital HM Modelo. La Coruña. España
  2. 2 Complexo Hospitalario Universitario de Santiago
    info

    Complexo Hospitalario Universitario de Santiago

    Santiago de Compostela, España

    ROR https://ror.org/00mpdg388

Revista:
Medicine: Programa de Formación Médica Continuada Acreditado

ISSN: 0304-5412

Ano de publicación: 2016

Título do exemplar: Enfermedades endocrinológicas y metabólicas (II) Patología suprarrenal

Serie: 12

Número: 14

Páxinas: 787-794

Tipo: Artigo

DOI: 10.1016/J.MED.2016.06.012 DIALNET GOOGLE SCHOLAR

Outras publicacións en: Medicine: Programa de Formación Médica Continuada Acreditado

Obxectivos de Desenvolvemento Sustentable

Resumo

Introduction Aldosterone is a mineralocorticoid hormone which regulates the sodium homeostasis, the plasma volume and the blood pressure. Etiopathogenia Hypoaldosteronisms are a group of syndromes characterized by decreased levels of aldosterone (or resistance to its action). Primary hyperaldosteronisms have elevated levels of aldosterone and decreased of levels of renin, mainly due to primary adrenal hyperplasia (60%) or an aldosteronoma (30%). Clinical Manifestations Hypoaldosteronisms present with hyponatremia, natriuresis, hypovolemia and hyperkalemia/metabolic acidosis. Hyperaldosteronisms produce hypertension, sometimes with hypokalemia and metabolic alkalosis. Diagnosis The association with a deficit of glucocorticoid should be discarded. The measurement of aldosterone and renin (basal / after stimulus) is necessary to guide the hypoaldosteronism diagnosis. The diagnosis of hyperaldosteronism requires a positive screening test and also a confirmation test; for differential diagnosis we should use adrenal CT and catheterization. Treatment In hypoaldosteronisms it is necessary to treat the precipitating cause and to administrate fludrocortisone. In hyperaldosteronisms the patient must be referred for surgery or treated with aldosterone antagonists according to the localization exams.

Referencias bibliográficas

  • Amar L, PlouinPF, Steichen O. Aldosterone-producing adenoma and othersurgicallycorrectableforms of primaryaldosteronism. Orphanet J RareDis. 2010;5:9.
  • Funder JW, Carey RM, Fardella C, Gómez-Sánchez CE, Mantero F, Stowasser M, et al. Case detection, diagnosis, and treatment of pa-tientswithprimary aldosteronism: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2008;93(9):3266-8.
  • Harvey AM. Hyperaldosteronism: diagnosis, lateralization, and treat-ment. Surg Clin North Am. 2014;94(3):643-56.
  • Monticone S, Viola A, Tizzani D, Crudo V, Burrello J, Galmozzi M, et al. Primary aldosteronism: who should be screened? Horm Metab Res. 2012;44(03):163-9.
  • Young WF. Endocrine hypertension. En: Williams textbook of endocri-nology. 12th ed. Melmed S, Polonsky KS, Larsen PR, Kronenberg HM. Philadelphia: Elsevier Saunders. 2011.
  • Young WF. Primaryaldosteronism: renaissance of a syndrome. Clin Endocrinol (Oxf). 2007;66(5):607-18.