HYPERALDOSTERONISM |
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DESCRIPTIONHyperaldosteronism is an endocrine disease caused by overproduction of aldosterone, a hormone manufactured by the adrenal glands. Excess aldosterone causes the kidneys to absorb too much sodium and water and to eliminate too much potassium. The adrenal glands (which are attached at the upper part of the kidneys), the kidneys, the fluids and electrolytes in the bloodstream, and other body cells are involved. Appropriate health care includes: self-care after diagnosis; physician's monitoring of general condition and medications; hospitalization; surgery to examine the adrenal glands and remove any tumors.
SIGNS & SYMPTOMS
General symptoms: fatigue and weakness; temporary paralysis (sometimes); tingling sensations in the arms, legs, hands, and feet; frequent urination, especially at night; thirst; severe muscle spasms; vision disturbances.
The following are apparent with diagnostic tests: low blood levels of potassium; high blood levels of sodium; high blood pressure.
CAUSES
Increased adrenal secretion of aldosterone. This is caused by the following:
A tumor of the adrenal gland.
High blood pressure or kidney disease, causing increased production in the kidneys of a hormone (renin) that controls aldosterone levels.
RISK FACTORS
A diet that contains large amounts of licorice; kidney disease; congestive heart failure; cirrhosis of the liver; use of oral contraceptives; use of diuretic drugs that cause potassium loss; pregnancy.
PREVENTING COMPLICATIONS OR RECURRENCE
A child who has kidney disease or high blood pressure should remain under a doctor's care and adhere strictly to the treatment program -- even if there are no symptoms.
BASIC INFORMATION
MEDICAL TESTS
Your own observation of symptoms.
Medical history and physical exam by a doctor.
Laboratory blood studies of electrolyte levels.
EKG (See Glossary).
Surgical diagnostic procedures such as laparoscopy (See Glossary).
X-rays of the kidneys.
Special studies that may include ultrasonography, CAT or CT scan, MRI, and radionuclide scan (See Glossary for all).
POSSIBLE COMPLICATIONS
Congestive heart failure.
Atherosclerosis.
Kidney failure.
PROBABLE OUTCOME
If your child's disorder is caused by an adrenal tumor, it is usually curable with surgery. If it is caused by kidney disease or high blood pressure, medical treatment for these disorders will control symptoms of hyperaldosteronism.
TREATMENT
HOME CARE
Weigh your child daily and keep a record. Report a gain of 3 or more pounds in a 24-hour period.
Encourage your child to wear a Medic-Alert bracelet or pendant (See Glossary).
MEDICATION
Your doctor may prescribe:
Cortisone drugs to replace adrenal hormones, if the adrenal gland is removed. This is essential for life. Don't let your child discontinue or change the dose without consulting your doctor.
Spironolactone to decrease the aldosterone effect if surgery is not performed. This drug may cause breast enlargement and sexual impotence in males.
See Medications section for information regarding medicines your doctor may prescribe.
ACTIVITY
No restrictions if surgery is not necessary. If it is, your child can resume normal activities gradually.
DIET & FLUIDS
Encourage your child to eat a diet that is low in sodium (See Appendix 29) and high in potassium. Foods rich in potassium include dried apricots and peaches, raisins, citrus fruits, lentils, and whole-grain cereals. Urge the child not to eat licorice.
OK TO GO TO SCHOOL?When appetite has returned and alertness, strength, and feeling of well-being will allow.
CALL YOUR DOCTOR IF
Your child has symptoms of hyperaldosteronism.
New, unexplained symptoms develop. Drugs used in treatment may produce side effects.
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