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A case with primary hyperaldosteronism associated with chronic kidney disease
Vilma Cadri1, Elvana Rista2, Florian Toti1
1University Hospital Center "Mother Teresa", Tirana, Albania.
Radiology Case Reports
|January 6, 2022
Summary
Primary hyperaldosteronism (PA) is a common cause of secondary hypertension and can worsen kidney function. Early diagnosis and treatment, like adrenalectomy, can improve blood pressure and renal health in resistant cases.
Area of Science:
- Endocrinology
- Nephrology
- Cardiology
Background:
- Primary hyperaldosteronism (PA) is a frequent cause of secondary hypertension.
- PA can lead to renal function decline and is found in approximately 20% of patients with resistant hypertension.
- Screening for PA is crucial in patients with resistant hypertension, especially those with chronic kidney disease (CKD).
Observation:
- A case study involving a patient with drug-resistant hypertension and CKD due to PA is presented.
- Despite dietary changes and multiple antihypertensive medications, the patient's blood pressure (BP) remained poorly controlled.
- Elevated aldosterone and renin levels, confirmed by imaging showing bilateral adrenal hyperplasia, indicated PA.
Findings:
- Unilateral adrenalectomy was performed due to persistent, poorly controlled BP.
- Post-surgery, the patient experienced significant improvements in both BP and renal function.
- This case highlights the diagnostic challenges of PA in CKD patients.
Implications:
- PA is a significant contributor to drug-resistant hypertension and CKD progression.
- Early identification and management of PA can prevent severe cardiovascular and renal complications.
- Routine screening for secondary hypertension, including PA, is recommended for patients with resistant hypertension and CKD.
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