Primary aldosteronism diagnosed in a patient with severe renal disease

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Published Oct 11, 2018
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Vol. 96 No. 7 (2018): Issue Jul 2018

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Meriam Hajji
Lamia Rais
Rania Kheder
Hela Jebali
Lilia Ben Fatma
Mohammed Karim Zouaghi

Abstract

Although initially considered a rarity, primary aldosteronism now is one of the more common causes of secondary hypertension. Based on older
data, it was originally estimated that primary aldosteronism accounted for less than 1% of all patients with hypertension. Subsequent data,
however, indicated that it may actually occur in as many as 5-15% of patients with hypertension. Here we present a 66-year-old patient with a
history of hypertension who was diagnosed with primary hyperaldosteronism at the time he had developed a severe renal failure secondary to
a vascular nephropathy. This case report illustrates the difficulties in diagnosis of primary hyperaldosteronism, and highlights the effects of the
delay of diagnosis on renal survival and on patient quality of life.

Keywords:

Severe Hypertension, Primary Aldosteronism, Renal Failure, Hemodialysis.

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References

  1. Rossi GP, Bernini G, Caliumi C, et al. A prospective study of the prevalence of primary aldosteronism in 1125 hypertensive patients. J Am CollCardiol. 2006;48:2293-300.
  2. Douma S, Petidis K, Doumas M, et al. Prevalence of primary hyperaldosteronism in resistant hypertension: a retrospective observational study. Lancet. 2008;371:1921-6.
  3. Stowasser M1. Update in primary aldosteronism.J ClinEndocrinolMetab. 2015;100(1):1-10..2014-3663.
  4. John W. Funder, Robert M. Carey, Franco Mantero, et al. The Management of PrimaryAldosteronism: Case Detection, Diagnosis, and Treatment: An Endocrine Society Clinical Practice Guideline. J Clin EndocrinolMetab. 2016 DOI: http://dx.doi.org/10.1210/jc.2015-4061
  5. Young, W.F. Jr& Klee, G.G. Primary aldosteronism. Diagnostic evaluation. Endocrinology and Metabolism Clinics of North America. 1988;17:367-95.
  6. Funder JW, Carey RM, Fardella C, et al. Endocrine Society. Case detection, diagnosis, and treatment of patients with primary aldosteronism: an Endocrine Society clinical practice guideline. J ClinEndocrinolMetab. 2008;93:3266-81.
  7. Kudva YC, SawkaAM, Young WF Jr. The laboratory diagnosis of adrenal pheochromocytoma: the Mayo Clinic experience. J ClinEndocrinolMetab 2003;88:4533-9.
  8. Young WF Jr. Primary aldosteronism: renaissance of a syndrome. Clin Endocrinol. 2007 May;66(5):607-18.
  9. Bravo EL, Fouad-Tarazi FM, Tarazi RC, Pohl M, Gifford RW, Vidt DG: Clinical implications of primary aldosteronism with resistant hypertension. Hypertension. 1988;11:I207-11.
  10. Kaplan NM. The current epidemic of primary aldosteronism: causes and consequences. J Hypertens. 2004;22:863-9.
  11. Weinberger MH, Grim CE, Hollifield JW, Kem DC, Gangualy A, Kramer NJ, Yune HY, Wellman H, Donohue JP: Primary aldosteronism: Diagnosis, localization, and treatment. Ann Intern Med90 :386- 395,1979
  12. Bravo EL, Tarzi RC, Dustan HP, Fouad FM, Textor SC, Gifford RW, Vidt DG: The changing clinical spectrum of primary aldosteronism. Am J Med74 :641- 651,1983
  13. Weinberger MH, Fineberg NS: The diagnosis of primary aldosteronism and separation of two major subtypes. Arch Intern Med. 1993;153:2125-9.
  14. Young, W.F.Secondary Hypertension: Clinical Presentation, Diagnosis and Treatment.Humana Press, Totowa, NJ. 2004;119-37.
  15. Kearney PM, Whelton M, Reynolds K, et al. Global burden of hypertension: analysis of worldwide data. Lancet. 2005;365:217-223.
  16. 11 Faselis C, Doumas M, Papademetriou V. Common secondary causes of resistant hypertension and rational for treatment. Int J Hypertens. 2011;2011:236239.
  17. Rye P, So B, Harvey A, et al. Unadjusted plasma renin activity as a ‘first look' test to decide upon further investigations for primary aldosteronism. J Clin Hypertens. 2015;17:541-6.
  18. Kline GA, Pasieka JL, Harvey A, et al. High-probability features of primary aldosteronism may obviate the need for confirmatory testing without increasing false-positive diagnoses. J ClinHypertens. 2014;16:488-96.
  19. Mahmud A, Mahgoub M, Hall M, Feely J: Does aldosterone-to-renin ratio predict the antihypertensive effect of the aldosterone antagonist spironolactone? Am J Hypertens. 2005;18:1631-5.
  20. Karagiannis A. Treatment of primary aldosteronism: where are we now? Rev EndocrMetabDisord. 2011;12:15-20.
  21. Do HeeKim ,Hee Jin Kwon , Sang A. Jib , HyeRyoun Jang , Sin-Ho Jung , Jung-Han Kim, Jae Hyeon Kim, Jung Eun Lee. Riskfactors for renalimpairmentrevealedafterunilateraladrenalectomy in patients withprimaryaldosteronism.Medicine (2016) 95:27