Hyperaldosteronism - a condition in which the enhanced production of aldosterone by the adrenal cortex. Increased concentrations of aldosterone in the body accompanied by an increase in blood pressure and muscle weakness (myasthenia gravis).
The reason for enhanced production of aldosterone in the adrenal glands most often gormonolno-active adenoma (aldosteronoma) adrenal adenomas or sometimes these microadenomas is a lot. Cancer can produce adrenal aldosterone and deoxycorticosterone. Aldosterone is produced in the glomerular zone of the adrenal cortex and simple hyperplasia (increase) in the glomerular zone of the adrenal cortex may also lead to hyperaldosteronism. Sometimes to the increased production of aldosterone causes long-term use of certain medications (diuretics, oral contraceptives, laxatives).
Hyperaldosteronism occurs with some long-term chronic kidney disease, kidney tumors, and long-lasting hypertension. Manifestations of the disease are caused by excessive production of adrenal hormones aldosterone. Aldosterone in the body regulates the reabsorption of sodium and potassium release in renal tubule.
If the amount of aldosterone increases the body retained more sodium and excreted more potassium. In this case the blood accumulates in the sodium and potassium decreased. Together with sodium ions in the body and accumulates an excessive amount of fluid (water). Due to the excessive amount of fluid increases the kidneys for its elimination by the kidneys and reduced production of biologically active substances of its own - of renin.
Low potassium in the blood (gipokaliemichesky syndrome) leads to pathological changes in the kidneys (nephropathy gipokaliemicheskoe) and muscles (myasthenia gravis, degeneration of the heart muscle). Because of the delay occurs in the body of sodium accumulation in the walls of his small arteries (arterioles), swelling and edema of the walls, increasing their tone, which ultimately leads to increased blood pressure.
The first manifestation of hyperaldosteronism - usually high blood pressure. The patient has headaches, fatigue, discomfort and aching in the heart.
In the future there are muscle weakness, pain and muscle cramps. Sometimes it can be transient paralysis of the muscles. The attacks of muscle weakness may be aggravated by physical and mental stress.
There are complaints about the deterioration of vision.
In the kidneys lead to abnormalities in urination, nighttime urination, increased urine output.
There increase in heart rate, cardiac arrhythmia, resistant hypertension.
Diagnosis of hyperaldosteronism set on the basis of a combination of resistant hypertension and complaints of muscle weakness, changes in the kidneys. In the blood, show an increased amount of sodium, low potassium, increased aldosterone concentrations. Ultrasound and computed tomography detected increased adrenal gland.
Treatment depends on the primary hyperaldosteronism causes overproduction of aldosterone. If the reason for increased production of aldosterone was the adrenal adenoma, treatment usually surgical. Removes the adrenal gland (unilateral adrenalectomy) or remove the tumor. When adrenal hyperplasia is first assigned to medical therapy, with its inefficiencies, can be held bilateral removal of the adrenal glands.
For the prevention of acute adrenal insufficiency appointed glucocorticoids. For other causes and shall be appointed early in the disease nifedipine, amlodipine, enalapril, spironolactone (veroshpiron), potassium preparations. Sometimes you need to glucocorticoids.
Necessarily assigned to a diet with increased content of the diet of foods rich in potassium (apricots, raisins, rice, potatoes) and low in salt.