Hypoaldosteronism is a type of hormone disorder characterized by the insufficient production or impaired functioning of a hormone called aldosterone. Aldosterone balances the sodium and potassium levels in the blood. There are two types of hypoaldosteronism depending on the renin (an enzyme that regulates the body’s aldosterone level) levels. These include:
- Hyporeninemic hypoaldosteronism in which there is decreased production of aldosterone due to decreased production of renin. This disorder is found in people with kidney diseases such as diabetes, interstitial nephritis, or multiple myeloma
- Hyperreninemic hypoaldosteronism in which there is a problem with aldosterone production while the renin is produced normally by the kidneys. This disorder can be caused by severe illness, medications (ACE inhibitors), aldosterone enzyme defects, or lead poisoning
Other causes of hypoaldosteronism include primary adrenal insufficiency, congenital adrenal hyperplasia and certain medications.
Symptoms
Symptoms for hypoaldosteronism include:
- Weight loss
- Low blood pressure
- Salt craving
- Palpitation
- Dizziness
- Lightheadedness
- Gastrointestinal disturbance
Diagnosis
Hypoaldosteronism may be suspected in an individual with high blood pressure, who does not respond to medications.
You will be asked to take a blood test to check for levels of renin and aldosterone in the blood.
To confirm the diagnosis, a 'salt challenge test' may be carried out. In this test, you will either be given a salt solution intravenously, or asked to consume a high-sodium diet for a few days. After administering either of the two methods, your aldosterone levels will be checked. In both cases, a normally healthy person’s aldosterone level should fall. If this does not happen, hyperaldosteronism is confirmed.
Treatment
Treatments offered for hypoaldosteronism depends on the underlying cause. You may be advised to follow a low potassium diet with increased sodium intake. You may be prescribed fludrocortisone which has a high degree of mineralocorticoid (corticosteroid hormone) effect and is similar to administering aldosterone.
