Current diagnosis and treatment of primary aldosteronism

Abstract

Primary aldosteronism is more common than previously recognized but much less common than most experts in this arena have recently stated. The recognition of autonomous hyperaldosteronism is not difficult but the identification of the source of excess aldosterone requires a costly and difficult procedure. Most patients with hyperaldosteronism turn out to have bilateral adrenal hyperplasia for which medical therapy with an aldosterone blocker is indicated. Many of these patients are not hypokalemic and can safely be treated without the need for a costly and usually negative work-up.

Keywords::

• adrenalectomy
• adrenal venous sampling
• eplerenone
• plasma renin activity
• primary aldosteronism
• spironolactone

Financial & competing interests disclosure

The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Notes

ARR: Aldosterone:renin ratio; PRA: Plasma renin activity; PRC: Plasma renin concentration.

Modified from [6].