Related Experiment Video
Updated: Jan 15, 2026

A Novel Method: Super-selective Adrenal Venous Sampling
Published on: September 15, 2017
The Story of Aldosterone Escape
Dillan Prasad1, Austin Drysch1, Deep Upadhyay1
1Northwestern University Feinberg School of Medicine, Chicago, Illinois.
None:
Aldosterone escape refers to the spontaneous and compensatory diuresis that occurs in primary aldosteronism to correct and rebalance fluid homeostasis during conditions of sodium retention. Although widely observed in humans and animals, the precise mechanisms underpinning aldosterone escape remain unclear. The escape phenomenon is clinically relevant as primary aldosteronism affects nearly one in ten hypertensive adults and is associated with a two-fold higher risk of stroke and atrial fibrillation. Studying the phenomenon provides additional insights into the intricate physiology of renal sodium handling that may inform future development of novel therapeutics. This review is a modern account of the complex interplay of renal hemodynamics, hormonal signaling, paracrine modulation, and tubular adaptations underlying aldosterone escape. By re-examining classical and emerging mechanisms, including the With-No-Lysine (WNK) kinase system as a potassium-sensitive distal homeostasis mechanism, we suggest a general framework for this remarkable phenomenon.
Related Concept Videos
Hormonal Regulation
Antihypertensive Drugs: Potassium-Sparing Diuretics
Hormones of the Adrenal Glands
The adrenal cortex, a powerhouse of hormone synthesis, generates over two dozen corticosteroid hormones. The zona glomerulosa produces mineralocorticoids, exemplified by aldosterone, influencing the electrolyte composition of body fluids. The synthesis of glucocorticoids such as cortisol and...
Antihypertensive Drugs: Angiotensin II Receptor Blockers
Regulation of Sodium and Potassium
Sodium Regulation
Sodium ions make up approximately 90% of extracellular cations, with a normal blood plasma concentration of 136–148 mEq/L. A decrease in blood volume and pressure triggers the release of renin from granular cells in the juxtaglomerular complex (JGC), primarily...
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

