Hypoaldosteronism classification
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
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.
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.
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 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.
| 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 | ||||||||||||||||||||||||||||||||||||||