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Adrenal: Hyperaldosteronism
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=== Primary === * '''<span style="color:#ff0000">Aldosterone secretion is independent of the RAAS''' ** '''<span style="color:#ff0000">Renin levels are suppressed''' * '''<span style="color:#ff0000">Can lead hypokalemia, hypomagnesemia, alkalosis, fluid depletion or retention, refractory hypertension, cardiac dysfunction and arrhythmias''' ** '''Hypernatremia does not occur because sodium reabsorption is accompanied by water uptake, thereby maintaining isotonicity.''' ** '''<span style="color:#ff0000">Most patients are normokalemic''' *** Although hypokalemia has been classically described as a common finding in primary aldosteronism, '''only 9-37% of newly diagnosed patients are hypokalemic''' ** Hypertension secondary to hyperaldosteronism is associated with an increased risk of end-organ damage compared with essential hypertension * '''<span style="color:#ff0000">Causes (8):''' *# '''Bilateral hyperplasia (60%), also referred to as idiopathic hyperplasia'''; *#* Clinically, patients with bilateral adrenal hyperplasia have less severe hypertension and are less likely to be hypokalemic compared with patients with aldosterone-producing adenomas *# '''Aldosterone-producing adrenal adenoma (35%)''' *# '''Unilateral adrenal hyperplasia (2%)''' *# '''Aldosterone-producing adrenal cortical carcinoma Β (<1%)''' *# '''Ectopic aldosterone-producing tumour (<1%)''' *# '''Familial hyperaldosteronism I (<1%)''' *#* '''Aldosterone production is mediated by ACTH in familial hyperaldosteronism type I''' *# '''Familial hyperaldosteronism II (<1%)''' *# '''Familial hyperaldosteronism III (<1%)'''
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