Primary Hyperaldosteronism
Autonomous aldosterone secretion with suppressed renin, causing sodium retention, hypertension and sometimes hypokalaemia; it is a treatable cause of secondary hypertension that may be unilateral or bilateral.
Definition
Primary aldosteronism is autonomous or partly autonomous adrenal aldosterone production with inappropriately suppressed renin. It causes sodium retention, volume expansion and hypertension, with hypokalaemia and alkalosis in more severe disease; it may be unilateral or bilateral.
First principles
Primary hyperaldosteronism is autonomous secretion, not appropriate activation
Normally, renin and angiotensin II stimulate aldosterone when renal perfusion or effective circulating volume falls. In primary aldosteronism, one or both adrenal glands produce aldosterone at least partly independently of this system, so sodium retention expands volume and suppresses renin. The biochemical pattern is inappropriately high aldosterone relative to suppressed renin, interpreted using the local assay and laboratory pathway.
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