Endocrinology / / May 03, 2016
Diseases associated with excessive production of aldosterone (aldosteronism)
In secondary aldosteronism there is an increased secretion of aldosterone, caused by chronic stimulation of glomerular zone of the adrenal cortex, which is implemented through the physiological control systems, regulating the secretion of aldosterone.This type of aldosteronism occurs as a response of the adrenal response to another disease or pathological condition.
In 1950, for the first time and Luetscher Deming noted that in patients with various pathological conditions (nephrosis, decompensated heart decompensated cirrhosis with ascites, and others.) Stands urine factor retaining sodium in the body, and that the concentration of this substance is much higherthan healthy.Later Luetscher et al. Has been proven that the substance aldosterone.Further, many diseases in which secondary aldosteronism was detected were investigated.
secondary aldosteronism is particularly expressed in renal ischemia, due to the activation of th
When poliuricheskoy stage chronic kidney disease (chronic glomerulo- and pyelonephritis, nephrosclerosis, nephropathy) and primary hyperparathyroidism and secondary aldosteronism develops as a result of negative water-salt balance.
At heart diseases that occur with a combination of left and right ventricular failure, congestive liver and ascites was found increased aldosterone excretion in the urine.In this case, the increase in the level of aldosterone in blood and urine rather associated with decreasing function of liver cells and, therefore, insufficient inactivation aldosterone than increased secretion by the adrenal cortex.
There are very conflicting data regarding the release of aldosterone excretion in hypertensive disease.Yet it seems that the amount of aldosterone in this disease is greatly improved, especially in a long-term or malignant hypertension, and found varying amounts of aldosterone, depending on the stage of hypertension.In the early stages of the disease aldosterone excretion increased only in some patients in later stages - the overwhelming number of patients.In hypertensive disease really is an increase of aldosterone, but only in the presence of severe heart failure.
In acute and chronic hepatitis observed normal excretion of aldosterone, although there are some reports indicating increased release it with urine.always significantly increased, and this increase should rather be attributed to reduced aldosterone inactivating function of liver cells with decompensated liver cirrhosis with ascites aldosterone.
- androgen-producing tumors of the adrenal cortex
- Primary aldosteronism (Conn's syndrome)
- Clinical evaluation of laboratory studies of the functional state of the adrenal cortex
- feminizing tumor of the adrenal cortex
- Diagnosis and differential diagnosis of congenitaladrenal hyperplasia
- Treatment of chronic adrenal insufficiency
- congenital (inborn) hyperaldosteronism
Regarding the increase of aldosterone during pregnancy, there are different views.In uncomplicated pregnancy we found normal amounts of aldosterone and only when toxemia and especially predeklampticheskom period aldosterone excretion increased significantly.Hernando found in the first half of pregnancy increased urinary excretion of aldosterone, while the second half of pregnancy decreased amount of aldosterone.Also found in pregnancy figures of aldosterone in the urine several times higher than the normal level.
After birth, aldosterone levels quickly return to normal.Do lies in the base allocation increase aldosterone urine pregnancy increased secretion of adrenal cortex hormone is believed to Jones et al., There is a reduction or collapse of aldosterone in the liver is not yet completely elucidated.
As can be seen from the above, secondary aldosteronism has at its basis an increase of aldosterone, caused or enhanced secretion, caused by excessive amounts of renin - angiotensin, or a sharp decrease in aldosterone metabolic breakdown in the liver.
Treatment of secondary aldosteronism - is primarily treatment of the primary disease, but also to apply and aldosterone antagonists - spironolactone.