№ 12Endocrinology13 min read
Primary and secondary hyperaldosteronism
1. Big picture
Hyperaldosteronism = too much aldosterone effect. Aldosterone acts in the distal nephron to retain sodium and water and excrete potassium and hydrogen ions. Therefore, the classic clinical-laboratory pattern is:
hypertension + hypokalemia + metabolic alkalosis
The key exam distinction is:
| Type | Aldosterone | Renin | Core mechanism |
|---|---|---|---|
| Primary hyperaldosteronism | High | Low | Autonomous adrenal aldosterone production |
| Secondary hyperaldosteronism | High | High | Renin-angiotensin-aldosterone system activation due to renal hypoperfusion or low effective arterial volume |
Primary hyperaldosteronism is also called primary aldosteronism. Conn syndrome classically means aldosterone-producing adrenal adenoma, but in exams it is often used broadly for primary aldosteronism.
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