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{{Hypoaldosteronism}}
{{Hypoaldosteronism}}


{{CMG}}; {{AE}}  
{{CMG}}; {{AE}}{{Akshun}}
==Overview==
==Overview==
Hypoaldosteronism may be classified into two categories depending on the level of plasma renin and depending on the level of aldosterone into hyporeninemic hypoaldosteronism or hyperreninemic hypoaldosteronism, and aldosterone deficiency or aldosterone resistance.
Hypoaldosteronism may be classified on the basis of [[Plasma renin activity|plasma renin]] levels into hyporeninemic hypoaldosteronism and hyperreninemic hypoaldosteronism. Hypoaldosteronism can also  be classified on the basis of plasma [[aldosterone]] levels into [[aldosterone]] deficiency and [[aldosterone]] resistance.


==Classification==
==Classification==
Hypoaldosteronism may be classified into two categories depending on the level of plasma renin and depending on the level of aldosterone into hyporeninemic hypoaldosteronism or hyperreninemic hypoaldosteronism, and aldosterone deficiency or aldosterone resistance.
Hypoaldosteronism may be classified on the basis of [[Plasma renin activity|plasma renin]] levels into hyporeninemic hypoaldosteronism and hyperreninemic hypoaldosteronism. Hypoaldosteronism can also  be classified on the basis of plasma [[aldosterone]] levels into [[aldosterone]] deficiency and [[aldosterone]] resistance.<ref name="BatlleKurtzman1982">{{cite journal|last1=Batlle|first1=Daniel|last2=Kurtzman|first2=Neil A.|title=Distal Renal Tubular Acidosis: Pathogenesis and Classification|journal=American Journal of Kidney Diseases|volume=1|issue=6|year=1982|pages=328–344|issn=02726386|doi=10.1016/S0272-6386(82)80004-8}}</ref><ref name="pmid17647140">{{cite journal |vauthors=Diederich S, Mai K, Bähr V, Helffrich S, Pfeiffer A, Perschel FH |title=The simultaneous measurement of plasma-aldosterone- and -renin-concentration allows rapid classification of all disorders of the renin-aldosterone system |journal=Exp. Clin. Endocrinol. Diabetes |volume=115 |issue=7 |pages=433–8 |year=2007 |pmid=17647140 |doi=10.1055/s-2007-973061 |url=}}</ref><ref name="pmid14969655">{{cite journal |vauthors=Brewster UC, Perazella MA |title=The renin-angiotensin-aldosterone system and the kidney: effects on kidney disease |journal=Am. J. Med. |volume=116 |issue=4 |pages=263–72 |year=2004 |pmid=14969655 |doi=10.1016/j.amjmed.2003.09.034 |url=}}</ref><ref name="pmid17032723">{{cite journal |vauthors=Nimkarn S, Lin-Su K, Berglind N, Wilson RC, New MI |title=Aldosterone-to-renin ratio as a marker for disease severity in 21-hydroxylase deficiency congenital adrenal hyperplasia |journal=J. Clin. Endocrinol. Metab. |volume=92 |issue=1 |pages=137–42 |year=2007 |pmid=17032723 |doi=10.1210/jc.2006-0964 |url=}}</ref>
 
 
===Based on the level of plasma renin===
 
Hypoaldosteronism can be classified on the basis of [[plasma renin activity]] into hyporeninemic or hyperreninemic hypoaldosteronism.


==Based on the level of plasma renin==


Hypoaldosteronism can be classified on the basis of plasma renin activity into hyporeninemic or hyperreninemic hypoaldosteronism.


{{familytree/start}}
{{familytree/start}}
{{familytree | | | | | | | | A01 |A01=Hypoaldosteronism}}  
{{familytree | | | | | | | | A01 |A01=Hypoaldosteronism}}  
{{familytree | | | | |,|-|-|-|^|-|-|-|-|.| | | }}
{{familytree | | | |,|-|-|-|-|^|-|-|-|-|.| | | }}
{{familytree | | | B01 | | | | | | | | B02 | | |B01=Hyporeninemic Hypoaldosteronism|B02=Hyperreninemic Hypoaldosteronism}}
{{familytree | | | B01 | | | | | | | | B02 | | |B01=Hyporeninemic Hypoaldosteronism|B02=Hyperreninemic Hypoaldosteronism}}
{{familytree | | | |!| | | | | | | | | |!| | | }}
{{familytree | | | |!| | | | | | | | | |!| | | }}
{{familytree | | | C01 | | | | | | | | C02 | | | | |C01= •Renal insufficiency<br> •Diabetic nephropathy<br> •Sickle cell disease<br>| C02= •Addison's disease<br> • Any severe illness such as malignancy or sepsis  | }}
{{familytree |boxstyle=text-align: left; | | | C01 | | | | | | | | C02 | | | | |C01= • [[Renal insufficiency]]<br> • [[Diabetic nephropathy]]<br> • [[Sickle cell disease]]<br>| C02= • [[Addison's disease]]<br> • Any severe [[illness]] such as [[malignancy]] or [[sepsis]] | }}
{{familytree/end}}
{{familytree/end}}


==Based on the level of aldosterone==


Hypoaldosteronism can be classified on the level of aldosterone. Deficiency in aldosterone is seen with disorders of kidney or adrenal gland and drugs inhibiting aldosterone synthesis. Alternatively, patients with normal to increased levels of aldosterone have end organ resistance to the action of aldosterone. These conditions include mineralocorticoid receptor defects and drugs inhibiting action of aldosterone.
===Based on the level of aldosterone===
 
Hypoaldosteronism can also be classified on the basis of level of [[aldosterone]].
 
 
 
{{familytree/start}}
{{familytree/start}}
{{familytree | | | | | | | | A01 |A01=Hypoaldosteronism}}  
{{familytree | | | | | | | | A01 |A01=Hypoaldosteronism}}  
{{familytree | | | | |,|-|-|-|^|-|-|-|-|.| | | }}
{{familytree | | | |,|-|-|-|-|^|-|-|-|-|.| | | }}
{{familytree | | | B01 | | | | | | | | B02 | | |B01=Aldosterone deficiency|B02=Aldosterone resistance}}
{{familytree | | | B01 | | | | | | | | B02 | | |B01=[[Aldosterone]] deficiency|B02=[[Aldosterone]] resistance}}
{{familytree | | | |!| | | | | | | | | |!| | | }}
{{familytree | | | |!| | | | | | | | | |!| | | }}
{{familytree | | | C01 | | | | | | | | C02 | | | | |C01= •Renal insufficiency<br> •Adrenal insufficiency<br> • Diabetic nephropathy<br> •Sickle cell disease<br> •Critical illness <br> •Congenital isolated hypoaldosteronism<br> • Drugs such as ACEi, ARBs and Heparin| C02= • Pseudohypoaldosteronism type 1<br>• Aldosterone antagonists<br>• Epithelial sodium channel blockers <br>  • Calcineurin inhibitors | }}
{{familytree |boxstyle=text-align: left; | | | C01 | | | | | | | | C02 | | | | |C01= • [[Renal insufficiency]]<br> • [[Adrenal insufficiency]]<br> • [[Diabetic nephropathy]]<br> • [[Sickle cell disease]]<br> • Critical [[illness]] <br> • Congenital isolated hypoaldosteronism<br> • Drugs such as [[ACE]]i, [[ARBs]] and [[Heparin]]| C02= • [[Pseudohypoaldosteronism]] type 1<br>• [[Aldosterone antagonists]]<br>• Epithelial sodium channel blockers <br>  • [[Calcineurin inhibitor]]s | }}
{{familytree/end}}
{{familytree/end}}


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{{WH}}
{{WH}}
{{WS}}
{{WS}}
[[Category:Disease]]
[[Category:Endocrinology]]
[[Category:Nephrology]]
[[Category:Emergency medicine]]
[[Category:Medicine]]
[[Category:Up-To-Date]]

Latest revision as of 16:37, 18 October 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Akshun Kalia M.B.B.S.[2]

Overview

Hypoaldosteronism may be classified on the basis of plasma renin levels into hyporeninemic hypoaldosteronism and hyperreninemic hypoaldosteronism. Hypoaldosteronism can also be classified on the basis of plasma aldosterone levels into aldosterone deficiency and aldosterone resistance.

Classification

Hypoaldosteronism may be classified on the basis of plasma renin levels into hyporeninemic hypoaldosteronism and hyperreninemic hypoaldosteronism. Hypoaldosteronism can also be classified on the basis of plasma aldosterone levels into aldosterone deficiency and aldosterone resistance.[1][2][3][4]


Based on the level of plasma renin

Hypoaldosteronism can be classified on the basis of plasma renin activity into hyporeninemic or hyperreninemic hypoaldosteronism.


 
 
 
 
 
 
 
Hypoaldosteronism
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Hyporeninemic Hypoaldosteronism
 
 
 
 
 
 
 
Hyperreninemic Hypoaldosteronism
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Renal insufficiency
Diabetic nephropathy
Sickle cell disease
 
 
 
 
 
 
 
Addison's disease
• Any severe illness such as malignancy or sepsis
 
 
 
 
 


Based on the level of aldosterone

Hypoaldosteronism can also be classified on the basis of level of aldosterone.


 
 
 
 
 
 
 
Hypoaldosteronism
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Aldosterone deficiency
 
 
 
 
 
 
 
Aldosterone resistance
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Renal insufficiency
Adrenal insufficiency
Diabetic nephropathy
Sickle cell disease
• Critical illness
• Congenital isolated hypoaldosteronism
• Drugs such as ACEi, ARBs and Heparin
 
 
 
 
 
 
 
Pseudohypoaldosteronism type 1
Aldosterone antagonists
• Epithelial sodium channel blockers
Calcineurin inhibitors
 
 
 
 
 

References

  1. Batlle, Daniel; Kurtzman, Neil A. (1982). "Distal Renal Tubular Acidosis: Pathogenesis and Classification". American Journal of Kidney Diseases. 1 (6): 328–344. doi:10.1016/S0272-6386(82)80004-8. ISSN 0272-6386.
  2. Diederich S, Mai K, Bähr V, Helffrich S, Pfeiffer A, Perschel FH (2007). "The simultaneous measurement of plasma-aldosterone- and -renin-concentration allows rapid classification of all disorders of the renin-aldosterone system". Exp. Clin. Endocrinol. Diabetes. 115 (7): 433–8. doi:10.1055/s-2007-973061. PMID 17647140.
  3. Brewster UC, Perazella MA (2004). "The renin-angiotensin-aldosterone system and the kidney: effects on kidney disease". Am. J. Med. 116 (4): 263–72. doi:10.1016/j.amjmed.2003.09.034. PMID 14969655.
  4. Nimkarn S, Lin-Su K, Berglind N, Wilson RC, New MI (2007). "Aldosterone-to-renin ratio as a marker for disease severity in 21-hydroxylase deficiency congenital adrenal hyperplasia". J. Clin. Endocrinol. Metab. 92 (1): 137–42. doi:10.1210/jc.2006-0964. PMID 17032723.

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