Hypoaldosteronism is a deficiency in aldosterone, a steroid hormone normally produced by the adrenal gland. In patients with hypoaldosteronism, production of other hormones in the adrenal gland may be normal, with just this hormone out of balance, depending on the cause. To treat this condition, a doctor needs to find out why the patient is experiencing a deficiency and develop an appropriate treatment plan to address the low aldosterone levels and their underlying cause. Patients can have hypoaldosteronism without obvious symptoms, especially in the early stages.
Aldosterone is involved in the process of regulating the balance of salt and potassium retained and excreted by the kidneys. A key sign of hypoaldosteronism is very high potassium levels. The patient may have hyporeninemic aldosteronism, where the production of an enzyme known as renin in the kidneys is lower than unusual, or the hyperreninemic form, where the kidneys continue producing this enzyme in normal concentrations. A doctor will determine which kind a patient has in the process of developing a diagnosis and determining the impact of the deficiency on kidney function.
One potential cause is a problem with the adrenal gland. Certain medications can also lead to hypoaldosteronism, including medications used to control blood pressure. Kidney failure and severe kidney disease are also potential causes. Patients with diabetes are at increased risk of hypoaldosteronism, especially if their condition is poorly controlled. Chronic disease in general can also make people more susceptible to complications like hypoaldosteronism as a result of stress on the metabolism.
A doctor can identify the deficiency by looking at concentrations of hormones in the blood and checking on other blood chemistry levels like sodium and potassium to collect more information potentially relevant to the diagnoses. Aldosterone therapy can be provided to bring levels of this hormone back to normal. This should stabilize the patient's potassium levels and may also help address blood pressure problems, as aldosterone is involved in the regulation of blood pressure.
The underlying cause also needs to be identified and treated, if possible. This may require changing medications to get the patient off a drug known to cause hypoaldosteronism, evaluating the patient for adrenal gland disease, or developing a new treatment plan for diabetes to better control and monitor the disease. If the cause is not treated, the patient will continue to experience hormone imbalances and can develop complications if the underlying disease is progressive in nature.