Secondary hyperaldosteronism is increased adrenal aldosterone production in response to a nichthypophysäre, extraadrenale stimulation as in a renal hypoperfusion. The symptoms are the same as for primary aldosteronism. The diagnosis involves the measurement of plasma Aldosteronwerten and plasma renin activity. Treatment consists of treating the causes.

Secondary hyperaldosteronism is increased adrenal aldosterone production in response to a nichthypophysäre, extraadrenale stimulation as in a renal hypoperfusion. The symptoms are the same as for primary aldosteronism. The diagnosis involves the measurement of plasma Aldosteronwerten and plasma renin activity. Treatment consists of treating the causes.

(Preparation of adrenal function.) Secondary hyperaldosteronism is increased adrenal aldosterone production in response to a nichthypophysäre, extraadrenale stimulation as in a renal hypoperfusion. The symptoms are the same as for primary aldosteronism. The diagnosis involves the measurement of plasma Aldosteronwerten and plasma renin activity. Treatment consists of treating the causes. A secondary hyperaldosteronism is caused by a decreased renal blood flow, which stimulates the renin-angiotensin system and leads to an increased aldosterone secretion. The causes of a reduced renal blood flow are obstruction of the renal artery (eg., By an atheroma or stenosis), renal vasoconstriction (as occurs in severe hypertension) and diseases associated with edema formation (eg. As heart failure, cirrhosis with ascites, nephrotic Syndrome). When heart failure aldosterone secretion may be normal, but the hepatic blood flow and the Aldosteronmetabolismus are limited, so the circulating hormone levels are high. Symptoms and signs The symptoms are similar to those in primary aldosteronism and include hypokalemic alkalosis, which may cause episodic weakness, paresthesias, transient paralysis, and tetany. In many cases, the only manifestation is a hypertension. Peripheral edema is possible. Diagnostic Serum electrolyte levels Plasmaaldosteron plasma renin activity (PRA), the incidence of hypertension and hypokalemia can be an indication of a Conn’s syndrome. The initial laboratory tests consist of determining the Plasmaaldosteronspiegel and PRA. Ideally, these determinations are performed after the patient drugs that affect the renin-angiotensin system (eg. As thiazide diuretics, ACE inhibitors, angiotensin antagonists, beta-blockers) discontinued for 4-6 weeks. Increased aldosterone and plasma renin activity is indicative of secondary aldosteronism. The main differences between primary and secondary aldosteronism are shown in differential diagnosis of hyperaldosteronism .. differential diagnosis of hyperaldosteronism. Clinical findings Primary hyperaldosteronism Secondary hyperaldosteronism adenoma hyperplasia Renal or accelerated hypertension Oedematous disorders blood pressure ?? ? ???? N or ? edema Rarely Rarely Rarely Available Serum sodium N or N or ? ? ? N or N or ? serum potassium ? ? ? N or N or ? plasma renin activity * ?? ?? ?? ? ? aldosterone ? ?? ? * When adjusted for age; Elderly patients have a lower mean plasma renin activity. ???? = greatly increased; ?? = greatly increased; = Increased ?; ?? = fell sharply; ? = decreased; N = normal. Therapy treating the cause Sometimes aldosterone antagonists Treatment involves correcting the cause. High blood pressure in these patients usually by a selective Aldosteronblocker such. B. spironolactone controlled. One starts with 50 mg p.o. 1 times a day and this dose increased within 1 to 3 months to the maintenance dose, which is a 1-times daily at 100 mg or it is used another potassium-sparing diuretic. The specific acting drug Eplerenone 50 mg p.o. up to 200 mg po 1 times a day can be used two times a day, because unlike spironolactone, it does not block the androgen receptor, it is the drug of choice for long-term treatment in men. Key points The diagnosis is suspected in hypertensive patients with hypokalemia. Among the initial examinations include measurement of plasma aldosterone and plasma renin activity. Unlike primary aldosteronism plasma renin activity is increased. For therapy involves treating the causes. Hypertension can be controlled by aldosterone antagonists.

Health Life Media Team

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