Aldosterone

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Subject: Aldosterone

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Definition

  • Primary mineralocorticoid secreted by the adrenal zona glomerulosa. The role of aldosterone in metabolism is the control of sodium and potassium. Regulating sodium ion concentration, in turn, regulates fluid volume. Aldosterone acts to decrease excretion of sodium and increase the excretion of potassium at the kidney, sweat glands, and salivary glands.

  • Normal range:

    • 8:00–10:00 am (sitting): 3–34 ng/dL

    • 8:00–10:00 am (supine): 2–19 ng/dL

    • 4:00–6:00 pm (sitting): 2–23 ng/dL

Use

  • Diagnosis of primary hyperaldosteronism

  • Differential diagnosis of fluid and electrolyte disorders

  • Assessment of adrenal aldosterone production

Interpretation

Increased In

  • Primary aldosteronism

  • Secondary aldosteronism

  • Barter syndrome

  • Pregnancy

  • Very low–sodium diet

  • Urine aldosterone also increased in nephrosis

Decreased In

  • Hyporeninemic hypoaldosteronism (Cushing syndrome)

  • CAH

  • Congenital deficiency of aldosterone synthetase

  • Addison disease

  • Very high–sodium diet

Limitations

  • Many physiologic factors affect plasma aldosterone. Posture, salt intake, use of antihypertensive drugs, use of steroids, oral contraceptives, age, stress, exercise, menstrual cycle, and pregnancy can all have a strong influence on aldosterone results.

  • Licorice may mimic aldosterone effects and should be avoided 2 weeks before the test.

 
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