What is the main cause of primary aldosteronism syndrome?

Updated: Mar 24, 2020
  • Author: Gabriel I Uwaifo, MD; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Answer

The cardinal anomaly causing primary aldosteronism syndrome is autonomous (nonsuppressible) aldosterone production. In addition to nonsuppressible aldosterone production, suppressed and poorly stimulative levels of plasma renin are coexisting with only mildly expanded intravascular and extravascular fluid volume. Normal regulation of aldosterone secretion is mediated to varying degrees by renin, serum potassium and sodium levels, intravascular volume status, and corticotropin.

Regulation of aldosterone production by these factors may be altered in various ways, depending on the subtype of primary aldosteronism. Generally, aldosterone-producing adenomas (APAs) and GRA remain corticotropin responsive, while idiopathic adrenal hyperplasia (IAH) and aldosterone-producing renin-responsive adenomas (RRAs) maintain responsiveness to the renin-angiotensin system (RAS).


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