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Hyper- and hypoaldosteronism.

D J Torpy1, C A Stratakis, G P Chrousos

  • 1National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland 20892, USA.

Vitamins and Hormones
|May 8, 1999
PubMed
Summary
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This review covers aldosterone disorders, including excess and deficiency. Primary aldosteronism and isolated aldosterone deficiency are highlighted for clinical management.

Area of Science:

  • Endocrinology
  • Nephrology
  • Genetics

Background:

  • Aldosterone regulates blood volume and potassium, with secretion controlled by the adrenal cortex.
  • Autonomous aldosterone hypersecretion causes hypertension and hypokalemia.
  • Normokalemic primary aldosteronism is more common than previously thought.

Purpose of the Study:

  • To review clinical disorders of aldosterone excess and deficiency.
  • To focus on primary aldosteronism and isolated aldosterone deficiency management.
  • To discuss the genetic basis and clinical features of various aldosteronism types.

Main Methods:

  • Literature review of clinical disorders related to aldosterone.
  • Analysis of genetic basis for conditions like glucocorticoid remediable aldosteronism and familial hyperaldosteronism type II.

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  • Examination of non-aldosterone mineralocorticoid excess causes.

    • Main Results:

    • Glucocorticoid remediable aldosteronism's genetic basis is understood.
    • Familial hyperaldosteronism type II is genetically distinct from known aldosterone synthesis genes.
    • Other causes of mineralocorticoid excess include congenital adrenal hyperplasia, apparent mineralocorticoid excess, Liddle's syndrome, and exogenous sources.
    • Hypoaldosteronism can result from inadequate stimulation, synthesis defects, or aldosterone resistance (e.g., pseudohypoaldosteronism type I).

    Conclusions:

    • Clinical management of aldosterone excess and deficiency requires understanding diverse etiologies.
    • Primary aldosteronism and isolated aldosterone deficiency are key areas for clinical focus.
    • Genetic factors play a significant role in several aldosterone-related disorders.