What is Hyperaldosteronism?
Hyperaldosteronism is a disease caused by enhanced production of aldosterone by the adrenal cortex. An increased concentration of aldosterone in the body is accompanied by an increase in blood pressure and muscle weakness (myasthenia).
Causes of Hyperaldosteronism
The reason for the increased production of aldosterone in the adrenal glands most often is hormone-active adenoma (aldosterone) of the adrenal cortex, sometimes there are many such adenomas or microadenomas. Adrenal cancer can produce aldosterone and deoxycorticosterone. Aldosterone is produced in the glomerular zone of the adrenal cortex and simple hyperplasia (enlargement) of the glomerular zone of the adrenal cortex can also lead to hyper aldosteronism. Sometimes long-term use of certain drugs (diuretics, oral contraceptives, laxatives) leads to increased production of aldosterone.
Hyperaldosteronism occurs in some long-term chronic kidney diseases, in renal tumors, and in long-term arterial hypertension. Manifestations of the disease are caused by excessive production of the hormone adrenal cortex aldosterone. Aldosterone in the body regulates sodium reabsorption and potassium excretion in the kidney tubules.
Pathogenesis during Hyperaldosteronism
If the amount of aldosterone increases, more sodium is retained in the body and more potassium is excreted. In the blood in this case, sodium accumulates, and the amount of potassium decreases. Along with sodium ions, an excessive amount of fluid (water) also accumulates in the body. In connection with the excess amount of fluid, the kidneys’ work on its removal increases and the kidneys produce their own biologically active substance, renin,.
Low amount of potassium in the blood (hypokalemic syndrome) leads to pathological changes in the kidneys (hypokalemic nephropathy) and muscles (myasthenia, dystrophy of the heart muscle). Due to the delay in the body of sodium, its accumulation occurs in the walls of small arterial vessels (arterioles), swelling and swelling of the walls, increasing their tone, which ultimately leads to an increase in blood pressure.
Symptoms of Hyperaldosteronism
The first manifestation of hyper aldosteronism is usually an increase in blood pressure. The patient has headaches, weakness, discomfort and aching pain in the heart area.
Further, muscle weakness, pain and muscle cramps. Sometimes transient muscle paralysis may occur. Attacks of muscle weakness may increase with physical and mental stress.
There are complaints of blurred vision.
On the part of the kidneys, urination disorders, night urination, and an increase in the volume of urine occur.
There is an increase in heart rate, heart rhythm disturbances, persistent arterial hypertension.
Diagnosis of Hyperaldosteronism
The diagnosis of hyper aldosteronism is established on the basis of a combination of persistent arterial hypertension and complaints of muscle weakness, changes in the kidneys. An increased amount of sodium, a low content of potassium, and an increase in the concentration of aldosterone are detected in the blood. With ultrasound and computed tomography, an enlarged adrenal gland is detected.
Treatment of Hyperaldosteronism
The treatment of hyper aldosteronism depends on the underlying cause of the overproduction of aldosterone. If the cause of increased production of aldosterone was adrenal gland adenoma, the treatment is often surgical. The adrenal gland is removed (unilateral adrenalectomy) or the tumor is removed. In case of adrenal hyperplasia, drug treatment is first prescribed; if it is ineffective, bilateral adrenal gland removal can be performed.
For the prevention of acute adrenal insufficiency, glucocorticoids are prescribed. For other reasons and at the beginning of the disease nifedipine, amlodipine, enalapril, spironolactone (veroshpiron), potassium preparations are prescribed. Sometimes there is a need for the appointment of glucocorticoids.
Be sure to assign a diet with an increased content in the diet of foods rich in potassium (dried apricots, raisins, rice, potatoes) and low in salt.