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{{Hypoaldosteronism}}
{{Hypoaldosteronism}}


{{CMG}}; {{AE}}  
{{CMG}}; {{AE}}{{Akshun}}
==Overview==
==Overview==
Hypoaldosteronism may be classified on the basis of plasma renin level. The most common cause of hypoaldosteronism is renin deficiency. Hypoaldosteronism can be classified into hyporeninemic hypoaldosteronism and hyperreninemic hypoaldosteronism
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.


as a low-normal or a high renin state  activity.
==Classification==
Renin deficiency is the most common cause of hypoaldosteronism, occurring most often in older patients with mild, nonoliguric renal disease who often have insulin-dependent diabetes and potentially diabetic nephropathy.  
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>
Indomethacin and other prostaglandin synthesis inhibitors as well as autonomic dysfunction associated with prolonged bedrest can also result in hyporeninemic hypoaldosteronism.
 
 
 
There is no established system for the classification of [disease name].
 
OR
 
[Disease name] may be classified according to [classification method] into [number] subtypes/groups: [group1], [group2], [group3], and [group4].
 
OR


[Disease name] may be classified into [large number > 6] subtypes based on [classification method 1], [classification method 2], and [classification method 3].
[Disease name] may be classified into several subtypes based on [classification method 1], [classification method 2], and [classification method 3].


OR
===Based on the level of plasma renin===


Based on the duration of symptoms, [disease name] may be classified as either acute or chronic.
Hypoaldosteronism can be classified on the basis of [[plasma renin activity]] into hyporeninemic or hyperreninemic hypoaldosteronism.


OR


If the staging system involves specific and characteristic findings and features:
According to the [staging system + reference], there are [number] stages of [malignancy name] based on the [finding1], [finding2], and [finding3]. Each stage is assigned a [letter/number1] and a [letter/number2] that designate the [feature1] and [feature2].


OR
{{familytree/start}}
{{familytree | | | | | | | | A01 |A01=Hypoaldosteronism}}
{{familytree | | | |,|-|-|-|-|^|-|-|-|-|.| | | }}
{{familytree | | | B01 | | | | | | | | B02 | | |B01=Hyporeninemic Hypoaldosteronism|B02=Hyperreninemic Hypoaldosteronism}}
{{familytree | | | |!| | | | | | | | | |!| | | }}
{{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}}


The staging of [malignancy name] is based on the [staging system].


OR
===Based on the level of aldosterone===


There is no established system for the staging of [malignancy name].
Hypoaldosteronism can also be classified on the basis of level of [[aldosterone]].
 


==Classification==


*There is no established system for the classification of [disease name].
{{familytree/start}}
OR
{{familytree | | | | | | | | A01 |A01=Hypoaldosteronism}}
*[Disease name] may be classified according to [classification method] into [number] subtypes/groups:
{{familytree | | | |,|-|-|-|-|^|-|-|-|-|.| | | }}
**[group1]
{{familytree | | | B01 | | | | | | | | B02 | | |B01=[[Aldosterone]] deficiency|B02=[[Aldosterone]] resistance}}
**[group2]
{{familytree | | | |!| | | | | | | | | |!| | | }}
**[group3]
{{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 | }}
**[group4]
{{familytree/end}}
OR
*[Disease name] may be classified into [large number > 6] subtypes based on:
**[classification method 1]
**[classification method 2]
**[classification method 3]
*[Disease name] may be classified into several subtypes based on:
**[classification method 1]
**[classification method 2]
**[classification method 3]
OR
*Based on the duration of symptoms, [disease name] may be classified as either acute or chronic.
OR
*If the staging system involves specific and characteristic findings and features:
*According to the [staging system + reference], there are [number] stages of [malignancy name] based on the [finding1], [finding2], and [finding3]. Each stage is assigned a [letter/number1] and a [letter/number2] that designate the [feature1] and [feature2].
OR
*The staging of [malignancy name] is based on the [staging system].
OR
*There is no established system for the staging of [malignancy name].


==References==
==References==
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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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