Aldosteronism, Primary

Vicente T. San Martin, MD and Rodolfo J. Galindo, MD Reviewed 06/2017
 


BASICS

DESCRIPTION

  • Clinical syndrome of excess aldosterone production, independent of renin secretion, and nonsuppressible by sodium loading

  • Classically manifested by hypertension (HTN) and hypokalemia ...

DIAGNOSIS

HISTORY

  • Usually asymptomatic

  • ROS: headaches, muscle weakness, fatigue, cramping, polyuria, polydipsia, paresthesias, or tetany (due to the hypokalemia)

  • Family history of HTN (early onset, <4...

TREATMENT

  • Treat HTN and electrolyte abnormalities, particularly hypokalemia, if present.

  • Surgery is the definitive treatment for unilateral disease (5)[A].

  • Medical management with aldosterone antagonist...

ONGOING CARE

FOLLOWUP RECOMMENDATIONS

  • K+ supplements, anti-HTN therapy, and spironolactone may need to be stopped/decreased after surgery.

  • High Na+ diet may be needed to avoid the hyperkalemia that can ...

REFERENCES

Funder JW, Carey RM, Mantero F et al. The management of primary aldosteronism: case detection, diagnosis, and treatment: an Endocrine Society clinical practice guideline. J Clin Endocrinol...

ADDITIONAL READING

  • Funder JW. Genetic of primary aldosteronism. Front Horm Res.  2014;43:70–78. [View Abstract on OvidInsights]

  • Pizzolo F, Zorzi F, Chiecchi L et al. NT-proBNP, a useful tool in hy...

CODES

ICD10

  • E26.09 Other primary hyperaldosteronism

  • E26.01 Conn’s syndrome

  • E26.81 Bartter’s syndrome

  • E26.02 Glucocorticoid-remediable aldosteronism

ICD9

  • 255.10 Hyperaldosteronism, unspecified

  • 255.12 Conn’s s...

PEARLS

  • Screening for PA is recommended in patients with HTN with hypokalemia, HTN with adrenal incidentaloma, HTN with sleep apnea, HTN with stroke, drug-resistant HTN, and sustained HTN >150/100 m...

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