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Vol 64, No 4 (2013)
Review paper
Submitted: 2013-09-04
Accepted: 2013-09-04
Published online: 2013-09-04
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Primary aldosteronism — recent progress and current concepts

Sylwia Kołodziejczyk-Kruk, Włodzimierz Januszewicz, Mariola Pęczkowska, Aleksander Prejbisz, Wojciech Zgliczyński, Andrzej Januszewicz
DOI: 10.5603/EP.2013.0011
·
Endokrynol Pol 2013;64(4):312-318.

open access

Vol 64, No 4 (2013)
Reviews — Postgraduate Education
Submitted: 2013-09-04
Accepted: 2013-09-04
Published online: 2013-09-04

Abstract

Primary aldosteronism is the commonest form of hormone-related hypertension, with an estimated prevalence of 6–13% in the generalpopulation of hypertensive patients. Among patients with resistant hypertension, the proportion of PA is even higher. Through intensiveresearch in the field of basic science and the creation of large registries of patients with PA, it is possible to understand the effect ofexcess aldosterone not only on the cardiovascular system but also on the morphology and function of the other organs. Recent researchhas highlighted the differences in the regulation of calcium metabolism in patients with adrenal adenomas and PA. A lot of attention hasbeen paid to the improvement of diagnostic methods, with particular emphasis on adrenal vein sampling, which is becoming increasinglyimportant. In recent years there have been many publications on the prevalence of mutations in the potassium channel in patients withadrenal tumours and PA. A new form of familial hyperaldosteronism - FIII, has also been distinguished. Treatment of patients with PAstill relies on the use of mineralocorticoid receptor antagonists or adrenalectomy, preferably preceded by a confirmation of aldosteronesecretion lateralisation by adrenal vein sampling.

Abstract

Primary aldosteronism is the commonest form of hormone-related hypertension, with an estimated prevalence of 6–13% in the generalpopulation of hypertensive patients. Among patients with resistant hypertension, the proportion of PA is even higher. Through intensiveresearch in the field of basic science and the creation of large registries of patients with PA, it is possible to understand the effect ofexcess aldosterone not only on the cardiovascular system but also on the morphology and function of the other organs. Recent researchhas highlighted the differences in the regulation of calcium metabolism in patients with adrenal adenomas and PA. A lot of attention hasbeen paid to the improvement of diagnostic methods, with particular emphasis on adrenal vein sampling, which is becoming increasinglyimportant. In recent years there have been many publications on the prevalence of mutations in the potassium channel in patients withadrenal tumours and PA. A new form of familial hyperaldosteronism - FIII, has also been distinguished. Treatment of patients with PAstill relies on the use of mineralocorticoid receptor antagonists or adrenalectomy, preferably preceded by a confirmation of aldosteronesecretion lateralisation by adrenal vein sampling.

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Keywords

adrenalectomy, adrenal vein sampling (AVS), aldosterone-to-renin ratio (ARR), KCNJ5 mutation, mineralocorticoid receptor antagonist, primary aldosteronism (PA), KCNJ5 mutation

About this article
Title

Primary aldosteronism — recent progress and current concepts

Journal

Endokrynologia Polska

Issue

Vol 64, No 4 (2013)

Article type

Review paper

Pages

312-318

Published online

2013-09-04

Page views

1928

Article views/downloads

2653

DOI

10.5603/EP.2013.0011

Bibliographic record

Endokrynol Pol 2013;64(4):312-318.

Keywords

adrenalectomy
adrenal vein sampling (AVS)
aldosterone-to-renin ratio (ARR)
KCNJ5 mutation
mineralocorticoid receptor antagonist
primary aldosteronism (PA)
KCNJ5 mutation

Authors

Sylwia Kołodziejczyk-Kruk
Włodzimierz Januszewicz
Mariola Pęczkowska
Aleksander Prejbisz
Wojciech Zgliczyński
Andrzej Januszewicz

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