Hypoaldosteronism is a rare disorder that leads to highly discomforting symptoms. Read and know what is Hypoaldosteronism as well as its causes, symptoms, diagnosis and treatment.

Hypoaldosteronism Definition

It is a disorder marked by the deficiency or defective functioning of a steroid hormone known as Aldosterone, which is usually produced by the adrenal gland.

Hypoaldosteronism ICD 9 Code

The ICD 9 Code for Hypoaldosteronism is 255.1.

Hypoaldosteronism Types

Doctors and medical researchers have differentiated this condition into various types. These are:

Primary Hyperaldosteronism

Individuals with this type suffer from an adrenal gland defect that makes it release excess aldosterone. Most cases of this form result from the presence of a benign (noncancerous) tumor of the adrenal gland. It is most common in patients aged between 30 and 50. This disease is sometimes also referred to as “Conn Syndrome”.

Secondary Hyperaldosteronism

In this form, the additional aldosterone results from something external to the adrenal gland that appears similar to the primary condition. It is typically caused as a result of high blood pressure, though it may also be associated to other conditions like Nephrotic Syndrome Heart failure and Cirrhosis of the liver.

Hyporeninemic Hypoaldosteronism

The disease results from reduced yield of aldosterone due to lowered production of Renin, a Proteolytic enzyme released by the kidneys. Individuals affected by this disorder generally have renal (kidney) disorders due to presence of different conditions like multiple myeloma, diabetes or interstitial nephritis.

Hyperreninemic Hypoaldosteronism

This condition develops from a defect in Aldosterone production. This disease is usually caused due to aldosterone enzyme defects, lead poisoning, acute ailments and side effects of medications like ACE inhibitors. In this form, the enzyme Renin is produced in normal concentrations by the kidneys.

Hypoaldosteronism Symptoms

Individuals affected with this disease may not display any apparent symptoms, particularly in the initial stages. In the later stages, the symptoms of Hyperaldosteronism may include

• Anorexia
• Weight loss
• Hyperpigmentation
• Asthenia
• Postural hypotension

This condition, however, primarily has an impact on the blood pressure levels in the human body. It is frequently a cause of high blood pressure which may only be controlled by various medicines. Excessive increase in potassium levels is another major symptom of this disorder.

What Causes Hypoaldosteronism?

Some of the potential causes of Hypoaldosteronism are:

• Defects in the adrenal gland
• Side-effects of medications used for controlling blood pressure (certain NSAIDs, ACE inhibitors and diuretics)
• Kidney failure
• Acute kidney ailments

Presence of chronic disorders and diabetes can also make individuals more susceptible to this disease. Chronic conditions can put more stress on the metabolism, thereby leading to Hypoaldosteronism.

Hypoaldosteronism Diagnosis

Doctors can easily diagnose this disease simply by observing hormones concentration in the bloodstream of a suspected individual. Determining potassium and sodium levels in the blood can also help in detecting this disorder. A blood test is required for this.

Other medical examinations may include:

• Urine tests, to determine levels of Potassium or Aldosterone
• Renin secretion test
• Computed Tomography (CT scan) of the abdomen, to check for tumors indicative of Primary Hyperaldosteronism
• MRI (Magnetic Resistance Imaging), to detect tumors of the adrenal glands

Hyperaldosteronism Tests

The diagnosis of this condition is also performed by doctors with the aid of certain tests, like Aldosterone-Renin Test. It helps measure the level of Aldosterone and Renin in the bloodstream. If this examination yields positive results, other procedures may also be carried out to confirm the diagnosis. These involve:

• Saline Loading Test
• Oral Salt Loading Test
• Adrenal Vein Sampling
• Fludrocortisone Suppression Test (FST)

Hypoaldosteronism Differential Diagnosis

The differential diagnosis for this disorder involves distinguishing the condition from other similar diseases like:

• Renal Artery Stenosis
• Cushing’s Disease
• Liddle’s Syndrome
• Adrenal adenomas
• Bartter Syndrome
• Gitelman Syndrome

Hypoaldosteronism Treatment

The treatment of this disorder depends on which form of it a patient is suffering from. Cure also depends on finding out the impact of the deficiency of Renin on functioning of the kidneys.

In some patients, Aldosterone therapy may be used to restore normalcy in the hormone levels. This should stabilize potassium level in the patients and also help cure blood pressure problems, due to the involvement of Aldosterone in regulating blood pressure.

If possible, the diagnosis and treatment of the underlying cause of this disorder should also be performed. This may require:

• Change of medications, to substitute any drug known to give rise to Hypoaldosteronism
• Evaluating an individual for adrenal gland disease
• Developing a new plan for cure and management of conditions like diabetes

If the underlying cause is left untreated, affected individuals will continue to suffer from imbalances in hormone levels. They may also develop complications if the underlying condition is found to be progressive in nature.

Hypoaldosteronism Complications

Some of the possible complications of this condition are:

• Hyperkalemia
• Urinary sodium wasting, resulting in Hypotension and Volume depletion
• Gynecomastia (enhanced breasts in men)
• Impotence

In some acute cases, the condition may lead to decreased plasma volume thereby causing problems like circulatory insufficiency, hypotension and ultimately fatal shock.

Hypoaldosteronism Management

The management of this disease involves proper dietary and lifestyle modification. Individuals should try to follow a healthy, low sodium diet plan at home that primarily involves foods like

• Fruits
• Vegetables
• Grains
• Low-fat dairy products

Patients must also try to maintain a healthy body weight by exercising regularly and practicing aerobic workouts. It is better for such patients to severely restrict or completely give up smoking and drinking caffeine-based or alcoholic beverages. These can make the immune system stronger and help the body combat the condition in a much better manner.

Hyperaldosteronism Prognosis

With early diagnosis and cure, the prognosis for Primary Hyperaldosteronism is found to be quite good. In case of Secondary Hyperaldosteronism, the outcome depends on the underlying cause of the disease. For patients who are severely ill and affected with Hyperreninemic Hypoaldosteronism, mortality rate is found to be as high as 80%.

If you or anyone in your family is displaying the symptoms of Hyperaldosteronism, immediately get in touch with a health care provider. If diagnosed and treated early, you can achieve a faster recovery from this condition.

References:

http://www.nlm.nih.gov/medlineplus/ency/article/000330.htm

http://www.ailments.com/974/Hypoaldosteronism.html

http://www.patient.co.uk/doctor/Hyperaldosteronism.htm

http://rarediseases.info.nih.gov/GARD/Condition/2874/Hypoaldosteronism.aspx