HYPERALDOSTERONISM

General Information

DEFINITION--An endocrine disease caused by overproduction of aldosterone, a hormone manufactured by the adrenal gland. Excess aldosterone causes the kidneys to absorb too much sodium and water and eliminate too much potassium.

BODY PARTS INVOLVED--Adrenal glands, which are attached at the upper part of the kidneys; kidneys; fluids and electrolytes in the bloodstream and body cells.

SEX OR AGE MOST AFFECTED

• Both sexes, but more common in females.
• All ages, but most common in adults between ages 30 and 50.

SIGNS & SYMPTOMS

Fatigue and weakness. Temporary paralysis (sometimes). Tingling sensations in the arms, legs, hands and feet. Urinary frequency, especially at night. Thirst. Severe muscle spasms. Vision disturbances. The following are apparent with diagnostic tests:

• Low blood levels of potassium.
• High blood levels of sodium.
• High blood pressure.

CAUSES--

Increased adrenal secretion of aldosterone. This is caused by:

• A tumor of the adrenal gland.
• High blood pressure or kidney disease, causing increased production in the kidneys of a hormone (renin) that controls aldosterone levels.

RISK INCREASES WITH

• Diet that contains large amounts of licorice.
• Kidney disease.
• Congestive heart failure.
• Cirrhosis of the liver.
• Use of oral contraceptives.
• Use of diuretic drugs that cause potassium loss.
• Pregnancy.

HOW TO PREVENT--If you have kidney disease or high blood pressure, remain under a doctor's care and adhere strictly to your treatment program--even if you have no symptoms.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory blood studies of electrolyte levels.
• CT scan (See Glossary) of the kidneys and adrenal glands.

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment.
• Hospitalization and surgery to remove adrenal gland (adrenalectomy) in some patients.

POSSIBLE COMPLICATIONS

• Congestive heart failure.
• Atherosclerosis.
• Kidney failure.

PROBABLE OUTCOME--If the disorder is caused by an adrenal tumor, it is usually curable with surgery. If it is caused by kidney disease or high blood pressure, medical treatment for these disorders will control symptoms of hyperaldosteronism.

How To Treat

GENERAL MEASURES--

• Weigh daily and keep a record. Report a gain of 3 or more pounds in a 24-hour period.
• Wear a Medic-Alert bracelet or pendant (See Glossary) to identify your medical condition and any medications you take.

MEDICATION--Your doctor may prescribe:

• Spironolactone to decrease the aldosterone effect. This drug may cause breast enlargement and sexual impotence in men. Other drug options are amiloride and triamterene.
• High-blood pressure medication.

ACTIVITY--No restrictions, if surgery is not necessary. If it is, resume your normal activities gradually.

DIET--Eat a diet that is low in sodium and high in potassium. Foods rich in potassium include dried apricots and peaches, raisins, citrus fruits, lentils and whole-grain cereals. Don't eat black licorice.

Call Your Doctor If

• You have symptoms of hyperaldosteronism.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.