Hypoaldosteronism laboratory findings
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
A positive history of hypotension, muscle weakness and fatigue should raise suspicion for hypoaldosteronism. An elevated/reduced concentration of serum/blood/urinary/CSF/other [lab test] is diagnostic of [disease name].
OR
Laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].
OR
[Test] is usually normal among patients with [disease name].
OR
Some patients with [disease name] may have elevated/reduced concentration of [test], which is usually suggestive of [progression/complication].
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There are no diagnostic laboratory findings associated with [disease name].
Laboratory Findings
- Laboratory findings consistent with the diagnosis of hypoaldosteronism include:[1]
- Hyperkalemia
- Mild non-anion gap metabolic acidosis
- 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:[2][3][4][5]
| 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
- ↑ 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.
- ↑ Oster JR, Singer I, Fishman LM (1995). "Heparin-induced aldosterone suppression and hyperkalemia". Am. J. Med. 98 (6): 575–86. PMID 7778574.
- ↑ 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.
- ↑ 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.
- ↑ 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.