Primary Aldosteronism

Primary aldosteronism is autonomous aldosterone production from one or both adrenal glands. Aldosterone increases sodium reabsorption, expands extracellular fluid volume, and raises blood pressure; potassium and hydrogen-ion loss may produce hypokalaemia and metabolic alkalosis. Volume expansion suppresses renin. That is why the characteristic biochemical pattern is aldosterone that is high or inappropriately normal despite low renin. Potassium may remain normal, so a normal result does not remove the diagnosis. Once primary aldosteronism is confirmed, determining whether secretion is unilateral or bilateral matters because the treatment pathway changes.