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Hyperaldosteronisme

Sist oppdatert: Sist revidert:
Sist revidert av:


Definisjon:
Overproduksjon av aldosteron gir symptomer som følge av natriumretensjon og hypokalemi. Det skilles mellom primær (dominerer) og sekundær hyperaldosteronisme
Forekomst:
I Norge oppdages ca 5 tilfeller årlig
Symptomer:
Symptomer kan være muskelsvakhet, parestesier, hodepine, polyuri, tørste, tretthet
Funn:
Kliniske funn er hypertensjon
Diagnostikk:
Aktuelle prøver er natrium, kalium (hypokalemi), renin, aldosteron
Behandling:
Behandlingen kan være et valg mellom livslang medikamentell terapi eller kirurgi
  1. Grytaas MA, Bakke Å, Ueland GÅ, Jørgensen AP. Primær hyperaldosteronisme. Nasjonal veileder i endokrinologi. Versjon 2.8, publisert 15.12.2020. Siden lest 04.01.2021 www.prosedyrer.no  
  2. Funder JW, Carey RM, Mantero F, et al. The Management of Primary Aldosteronism: Case Detection, Diagnosis, and Treatment: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 2016; 101:1889. PubMed  
  3. Brown JM, Siddiqui M, Calhoun DA, et al. The Unrecognized Prevalence of Primary Aldosteronism A Cross-sectional Study. Ann Intern Med 2020; 173: 10-20. pmid:32449886 PubMed  
  4. Mulatero P, Stowasser M, Loh KC, et al. Increased diagnosis of primary aldosteronism, including surgically correctable forms, in centers from five continents. J Clin Endocrinol Metab 2004; 89: 1045. PubMed  
  5. Stowasser M. Primary Aldosteronism: Rare bird or common cause of secondary hypertension?. Curr Hypertens Rep 2001; 3: 230. PubMed  
  6. Hung A, Ahmed S, Gupta A, et al. Performance of the Aldosterone to Renin Ratio as a Screening Test for Primary Aldosteronism. J Clin Endocrinol Metab 2021; 106: 2423-35. pmid:34008000 PubMed  
  7. Pitt B, Zannad F, Remme WJ, et al. The effect of spironolactone on morbidity and mortality in patients with severe heart failure. N Engl J Med 1999; 341: 709. New England Journal of Medicine  
  8. Pitt B, Remme W, Zannad F, Neaton J. Eplerenone, a selective aldosterone blocker, in patients with left ventricular dysfunction after myocardial infarction. N Engl J Med 2003; 348: 1309. New England Journal of Medicine  
  9. Williams TA, Lenders JWM, Mulatero P, et al. Outcomes after adrenalectomy for unilateral primary aldosteronism: an international consensus on outcome measures and analysis of remission rates in an international cohort. Lancet Diabetes Endocrinol 2017; 5: 689-99. pmid:28576687 PubMed  
  10. Chen Y-Y, Lin Y-HH, Huang W-C, et al. Adrenalectomy Improves the Long-Term Risk of End-Stage Renal Disease and Mortality of Primary Aldosteronism. J Endocr Soc 2019; 3: 1110-26. pmid:31086833 PubMed  
  11. Monticone S, D'Ascenzo F, Moretti C, et al. Cardiovascular events and target organ damage in primary aldosteronism compared with essential hypertension: a systematic review and meta-analysis. Lancet Diabetes Endocrinol 2018; 6: 41-50. pmid:29129575 PubMed  
  12. Stowasser M, Gordon RD, Gunasekera TG, et al. High rate of detection of primary aldosteronism, including surgically treatable forms, after 'non-selective' screening of hypertensive patients. J Hypertens. 2003; 21: 2149-57. 14597859
  13. Sechi LA, Novello M, Lapenna R, et al. Long-term renal outcomes in patients with primary aldosteronism. JAMA 2006; 295: 2638-45. PubMed  
  • Terje Johannessen, professor i allmennmedisin, Trondheim
  • Cecilia Mattsson, docent och överläkare, Endokrinsektionen, Medicinkliniken, Norrlands universitetssjukhus, Umeå (Medibas)

Tidligere fagmedarbeidere

  • Kristian Løvås, Helse-Bergen