Hypoaldosteronism classification

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

↑ 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.
↑ 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.
↑ 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.
↑ 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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[BatlleKurtzman1982-1] 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.

[pmid17647140-2] 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.

[pmid14969655-3] 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.

[pmid17032723-4] 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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