Primary vs secondary hyperaldosteronsim,”Primary: Direct release of aldosterone (Ald>>Ren)Secondary: Direct release of renin (Ald ~= Ren)HTN, Low K (causes polyuria, polydypsia, metabolic alkalosis. No peripheral edemaCause-Adrenal adenoma (Conn’s syndrome)-Adrenal hyperplasia (almost always bilateral)Dx-Ald:Renin > 30 in primary-Saline infusion (normally this reduces aldosterone)-Oral Na loading: Give salt for 3 days –> if urine aldosterone is still high, this confirms the diagnosis-Adrenal venous sampling: If aldosterone is elevated on both sides

Primary vs secondary hyperaldosteronsim,”Primary: Direct release of aldosterone (Ald>>Ren)Secondary: Direct release of renin (Ald ~= Ren)HTN, Low K (causes polyuria, polydypsia, metabolic alkalosis. No peripheral edemaCause-Adrenal adenoma (Conn’s syndrome)-Adrenal hyperplasia (almost always bilateral)Dx-Ald:Renin > 30 in primary-Saline infusion (normally this reduces aldosterone)-Oral Na loading: Give salt for 3 days –> if urine aldosterone is still high, this confirms the diagnosis-Adrenal venous sampling: If aldosterone is elevated on both sides

it is hyperplasia; otherwise its adenomaTreat: Resect if adenoma; spironolactone if hyperplasia”