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Aldosteronism, Primary

Mariya Milko, MS, DO Reviewed 05/2023
 


BASICS

Increased production of aldosterone, usually due to abnormal zona glomerulosa tissue from hyperplasia or adenoma. 

DESCRIPTION

  • Clinical syndrome of excess aldosterone production, independent of r...

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 antagonis...

ONGOING CARE

FOLLOW-UP 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

1
Funder  JW, Carey  RM, Mantero  F, et al. The management of primary aldosteronism: case detection, diagnosis, and treatment: an Endocrine Society clinical practice ...

CODES

ICD10

  • E26.09 Other primary hyperaldosteronism

  • E26.01 Conn’s syndrome

  • E26.81 Bartter’s syndrome

  • E26.02 Glucocorticoid-remediable aldosteronism

SNOMED

  • 190507007 Primary hyperaldosteronism (disorder)

  • 1074...

CLINICAL PEARLS

  • PA screening is recommended in high-risk patients.

  • Calculate ARR in patients at increased risk.

  • Confirmed cases should undergo high-resolution CT scan to exclude ACC.

  • If surgery is desire...

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