Persistent Hypoaldosteronism Post-adrenalectomy for Primary Aldosteronism – a Role for Pre-operative Spironolactone?

Abstract/Summary:

Primary aldosteronism is one of the most common (affecting up to 10%) yet treatable causes of hypertension in our community, notable due to an associated elevated risk of atrial fibrillation, stroke and myocardial infarction compared to essential hypertension. Guidelines have focussed on improving case detection due to significant underdiagnosis in the community. While our case experienced significant delay in diagnosis, we highlight a state of protracted, persistent post-operative hypoaldosteronism which manifested with severe hyponatremia and hyperkalemia, necessitating long-term mineralocorticoid replacement. We discuss whether pre-operative mineralocorticoid receptor antagonists to stimulate aldosterone secretion from the contralateral gland may have prevented this complication.

Authors: Lachlan M Angus, Jun Yang, Ada S Cheung
Keywords: hypoaldosteronism, hyponatremia, hyperkalemia, adrenalectomy
DOI Number: 10.1530/EDM-21-0137      Publication Year: 2021

To search for other research papers by topic, keyword, author, or year, please go to our Publications page.

©2021 Primary Aldosteronism Foundation — All Rights Reserved

The Primary Aldosteronism Foundation is a registered 501(c)(3) public charity. Donations are tax deductible in the US.

©2021 Primary Aldosteronism Foundation

The Primary Aldosteronism Foundation is a registered 501(c)(3) public charity. Donations are tax deductible in the US.