Hypoaldosteronism classification

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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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