Hypoaldosteronism laboratory findings: Difference between revisions

Jump to navigation Jump to search
No edit summary
No edit summary
Line 5: Line 5:


==Overview==
==Overview==
Laboratory findings consistent with the diagnosis of hypoaldosteronism include hyperkalemia and mild non-anion gap metabolic acidosis. Other lab findings include hyponatremia, decreased aldosterone level, with variable amounts of plasma renin activity (depends upon underlying condition).
[[Laboratory]] findings consistent with the [[diagnosis]] of hypoaldosteronism include [[hyperkalemia]] and mild non-anion gap [[metabolic acidosis]]. Other [[Laboratory|lab]] findings include [[hyponatremia]], decreased [[aldosterone]] level, with variable amounts of [[plasma renin activity]] (depends upon underlying condition).


==Laboratory Findings==
==Laboratory Findings==
*Laboratory findings consistent with the diagnosis of hypoaldosteronism include:<ref name="pmid7613258">{{cite journal |vauthors=Shiah CJ, Wu KD, Tsai DM, Liao ST, Siauw CP, Lee LS |title=Diagnostic value of plasma aldosterone/potassium ratio in hypoaldosteronism |journal=J. Formos. Med. Assoc. |volume=94 |issue=5 |pages=248–54 |year=1995 |pmid=7613258 |doi= |url=}}</ref><ref name="LehnhardtKemper2010">{{cite journal|last1=Lehnhardt|first1=Anja|last2=Kemper|first2=Markus J.|title=Pathogenesis, diagnosis and management of hyperkalemia|journal=Pediatric Nephrology|volume=26|issue=3|year=2010|pages=377–384|issn=0931-041X|doi=10.1007/s00467-010-1699-3}}</ref>
*[[Laboratory]] findings consistent with the [[diagnosis]] of hypoaldosteronism include:<ref name="pmid7613258">{{cite journal |vauthors=Shiah CJ, Wu KD, Tsai DM, Liao ST, Siauw CP, Lee LS |title=Diagnostic value of plasma aldosterone/potassium ratio in hypoaldosteronism |journal=J. Formos. Med. Assoc. |volume=94 |issue=5 |pages=248–54 |year=1995 |pmid=7613258 |doi= |url=}}</ref><ref name="LehnhardtKemper2010">{{cite journal|last1=Lehnhardt|first1=Anja|last2=Kemper|first2=Markus J.|title=Pathogenesis, diagnosis and management of hyperkalemia|journal=Pediatric Nephrology|volume=26|issue=3|year=2010|pages=377–384|issn=0931-041X|doi=10.1007/s00467-010-1699-3}}</ref>
**Hyperkalemia
**[[Hyperkalemia]]
**Mild non-anion gap metabolic acidosis
**Mild non-anion gap [[metabolic acidosis]]


*Laboratory investigations to be performed in hypoaldosteronism includes:
*[[Laboratory]] investigations to be performed in hypoaldosteronism includes:
**Serum potassium: Hypoaldosteronism patients have hyperkalemia and should be categorised into mild hyperkalemia(5.5–6.5 mmol/l), moderate hyperkalemia (6.5–7.5 mmol/l) and severe hyperkalemia(>7.5 mmol/l).
**Serum [[potassium]]: Hypoaldosteronism patients have [[hyperkalemia]] and should be categorised into mild [[hyperkalemia]] (5.5–6.5 mmol/l), moderate [[hyperkalemia]] (6.5–7.5 mmol/l) and severe [[hyperkalemia]] (>7.5 mmol/l).
**Serum sodium: In general, hyponatremia is unusual in hypoaldosteronism but if the cause of hypoaldosteronism is adrenal insufficiency hyponatremia must be categorized into mild hyponatremia(130-134 mmol/L), moderate hyponatremia (125-129 mmol/L) and severe hyponatremia(<125 mmol/L).  
**Serum [[sodium]]: In general, [[hyponatremia]] is unusual in hypoaldosteronism but if the cause of hypoaldosteronism is [[adrenal insufficiency]], [[hyponatremia]] may be present. [[Hyponatremia]] must be categorized into mild [[hyponatremia]] (130-134 mmol/L), moderate [[hyponatremia]] (125-129 mmol/L) and severe [[hyponatremia]](<125 mmol/L).  
**Patients suspects of hypoaldosteronism should be checked for plasma renin activity (PRA), serum aldosterone, and serum cortisol.  
**[[Patients]] suspects of hypoaldosteronism should be checked for [[plasma renin activity]] (PRA), serum [[aldosterone]], and serum [[cortisol]].  
**The following table distinguishes among various subtypes of hypoaldosteronism:<ref name="pmid7778574">{{cite journal |vauthors=Oster JR, Singer I, Fishman LM |title=Heparin-induced aldosterone suppression and hyperkalemia |journal=Am. J. Med. |volume=98 |issue=6 |pages=575–86 |year=1995 |pmid=7778574 |doi= |url=}}</ref><ref name="pmid5444558">{{cite journal |vauthors=Mayes D, Furuyama S, Kem DC, Nugent CA |title=A radioimmunoassay for plasma aldosterone |journal=J. Clin. Endocrinol. Metab. |volume=30 |issue=5 |pages=682–5 |year=1970 |pmid=5444558 |doi=10.1210/jcem-30-5-682 |url=}}</ref><ref name="pmid18216310">{{cite journal |vauthors=Choi MJ, Ziyadeh FN |title=The utility of the transtubular potassium gradient in the evaluation of hyperkalemia |journal=J. Am. Soc. Nephrol. |volume=19 |issue=3 |pages=424–6 |year=2008 |pmid=18216310 |doi=10.1681/ASN.2007091017 |url=}}</ref><ref name="pmid25968592">{{cite journal |vauthors=Ruecker B, Lang-Muritano M, Spanaus K, Welzel M, l'Allemand D, Phan-Hug F, Katschnig C, Konrad D, Holterhus PM, Schoenle EJ |title=The Aldosterone/Renin Ratio as a Diagnostic Tool for the Diagnosis of Primary Hypoaldosteronism in Newborns and Infants |journal=Horm Res Paediatr |volume=84 |issue=1 |pages=43–8 |year=2015 |pmid=25968592 |doi=10.1159/000381852 |url=}}</ref>  
**The following table distinguishes among various subtypes of hypoaldosteronism:<ref name="pmid7778574">{{cite journal |vauthors=Oster JR, Singer I, Fishman LM |title=Heparin-induced aldosterone suppression and hyperkalemia |journal=Am. J. Med. |volume=98 |issue=6 |pages=575–86 |year=1995 |pmid=7778574 |doi= |url=}}</ref><ref name="pmid5444558">{{cite journal |vauthors=Mayes D, Furuyama S, Kem DC, Nugent CA |title=A radioimmunoassay for plasma aldosterone |journal=J. Clin. Endocrinol. Metab. |volume=30 |issue=5 |pages=682–5 |year=1970 |pmid=5444558 |doi=10.1210/jcem-30-5-682 |url=}}</ref><ref name="pmid18216310">{{cite journal |vauthors=Choi MJ, Ziyadeh FN |title=The utility of the transtubular potassium gradient in the evaluation of hyperkalemia |journal=J. Am. Soc. Nephrol. |volume=19 |issue=3 |pages=424–6 |year=2008 |pmid=18216310 |doi=10.1681/ASN.2007091017 |url=}}</ref><ref name="pmid25968592">{{cite journal |vauthors=Ruecker B, Lang-Muritano M, Spanaus K, Welzel M, l'Allemand D, Phan-Hug F, Katschnig C, Konrad D, Holterhus PM, Schoenle EJ |title=The Aldosterone/Renin Ratio as a Diagnostic Tool for the Diagnosis of Primary Hypoaldosteronism in Newborns and Infants |journal=Horm Res Paediatr |volume=84 |issue=1 |pages=43–8 |year=2015 |pmid=25968592 |doi=10.1159/000381852 |url=}}</ref>  
{| class="wikitable"
{| class="wikitable"

Revision as of 15:50, 31 August 2017

Hypoaldosteronism Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Hypoaldosteronism from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Criteria

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X Ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Hypoaldosteronism laboratory findings On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Hypoaldosteronism laboratory findings

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Hypoaldosteronism laboratory findings

CDC on Hypoaldosteronism laboratory findings

Hypoaldosteronism laboratory findings in the news

Blogs on Hypoaldosteronism laboratory findings

Directions to Hospitals Treating Hypoaldosteronism

Risk calculators and risk factors for Hypoaldosteronism laboratory findings

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

Overview

Laboratory findings consistent with the diagnosis of hypoaldosteronism include hyperkalemia and mild non-anion gap metabolic acidosis. Other lab findings include hyponatremia, decreased aldosterone level, with variable amounts of plasma renin activity (depends upon underlying condition).

Laboratory Findings

Disorder Plasma ReninActivity Plasma Aldosterone Plasma cortisol
Hyporeninemic hypoaldosteronism Low  Low  Normal
Hypereninemic hypoaldosteronism Increased Low  Normal/↓
Primary adrenal insufficiency High Low  Low 
Pseudohypoaldosteronism type I High High Normal
Pseudohypoaldosteronism type II Normal/↓ Normal/↓ Normal

References

  1. Shiah CJ, Wu KD, Tsai DM, Liao ST, Siauw CP, Lee LS (1995). "Diagnostic value of plasma aldosterone/potassium ratio in hypoaldosteronism". J. Formos. Med. Assoc. 94 (5): 248–54. PMID 7613258.
  2. Lehnhardt, Anja; Kemper, Markus J. (2010). "Pathogenesis, diagnosis and management of hyperkalemia". Pediatric Nephrology. 26 (3): 377–384. doi:10.1007/s00467-010-1699-3. ISSN 0931-041X.
  3. Oster JR, Singer I, Fishman LM (1995). "Heparin-induced aldosterone suppression and hyperkalemia". Am. J. Med. 98 (6): 575–86. PMID 7778574.
  4. Mayes D, Furuyama S, Kem DC, Nugent CA (1970). "A radioimmunoassay for plasma aldosterone". J. Clin. Endocrinol. Metab. 30 (5): 682–5. doi:10.1210/jcem-30-5-682. PMID 5444558.
  5. Choi MJ, Ziyadeh FN (2008). "The utility of the transtubular potassium gradient in the evaluation of hyperkalemia". J. Am. Soc. Nephrol. 19 (3): 424–6. doi:10.1681/ASN.2007091017. PMID 18216310.
  6. Ruecker B, Lang-Muritano M, Spanaus K, Welzel M, l'Allemand D, Phan-Hug F, Katschnig C, Konrad D, Holterhus PM, Schoenle EJ (2015). "The Aldosterone/Renin Ratio as a Diagnostic Tool for the Diagnosis of Primary Hypoaldosteronism in Newborns and Infants". Horm Res Paediatr. 84 (1): 43–8. doi:10.1159/000381852. PMID 25968592.

Template:WH Template:WS