Hiperaldosteronismo primario, una enfermedad no diagnosticada ¿o no sospechada?
DOI:
https://doi.org/10.18041/2665-427X/ijeph.2.9884Palabras clave:
aldosterona, algoritmo diagnóstico, hiperaldosteronismo primario, hipertensión arterial secundaria, reninaResumen
El hiperaldosteronismo primario es una condición directamente relacionada con la hipertensión arterial, siendo la primer etiología de origen secundaria; ante la baja sospecha el diagnostico no es comúnmente realizado, sin embargo cuenta con un protocolo diagnóstico de pocos pasos que incluye medición de actividad renina aldosterona, pruebas confirmatorias como el test de solución salina y estudios imagenológicos como la tomografía de glándulas suprarrenales; el manejo puede ser médico o quirúrgico, impactando en el control de cifras de presión arterial y gran número de patologías relacionadas como fibrilación auricular, obesidad y apnea hipopnea obstructiva del sueño, reduciendo la alta morbilidad y mortalidad de estas condiciones asociadas, por lo cual es muy importante reconocer medidas de tamizaje y diagnóstico del hiperaldosteronismo primario
Descargas
Referencias
Stowasser M, Gordon RD. Primary aldosteronism: changing definitions and new oncepts of physiology and pathophysiology both inside and outside the kidney. Physiol Rev 2016; 96: 1327–84. doi: 10.1152/physrev.00026.2015.
Acelajado MC, Hughes ZH, Oparil S, Calhoun DA. Treatment of resistant and refractory hypertension. Circ Res 2019; 124: 1061–70. doi: 10.1161/CIRCRESAHA.118.312156.
González AR, Londoño M del PU de A, Diaz J, Barrera CAB, Gutiérrez J. Incidentaloma adrenal: Acta Médica Colomb. 2015; 40(4):318–25.
Marney AM, Brown NJ. Aldosterone and end-organ damage. Clin Sci (Lond) 2007; 113: 267–78. doi: 10.1042/CS20070123.
Funder JW, Carey RM. Primary Aldosteronism: Where Are We Now? Where to from Here? Hypertension. 2022; 79(4):726–35. doi: 10.1161/HYPERTENSIONAHA.121.18761.
Brown JM, Siddiqui M, Calhoun DA, Carey RM, Hopkins PN, Williams GH, Vaidya A. The Unrecognized Prevalence of Primary Aldosteronism: A Cross-sectional Study. Ann Intern Med. 2020;173(1):10-20. doi: 10.7326/M20-0065.
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: 1889–916. doi: 10.1210/jc.2015-4061.
Mulatero P, Monticone S, Deinum J, et al. Genetics, prevalence, screening and confirmation of primary aldosteronism: a position statement and consensus of the Working Group on Endocrine Hypertension of The European Society of Hypertension. J Hypertens 2020; 38: 1919–28. doi: 10.1097/HJH.0000000000002510.
Nishikawa T, Omura M, Satoh F, Shibata H, Takahashi K, Tamura N, Tanabe A; Task Force Committee on Primary Aldosteronism, The Japan Endocrine Society. Guidelines for the diagnosis and treatment of primary aldosteronism--the Japan Endocrine Society 2009. Endocr J. 2011;58(9):711-21. doi: 10.1507/endocrj.ej11-0133.
Funder JW, Carey RM, Fardella C, Gomez-Sanchez CE, Mantero F, Stowasser M, et al. Case detection, diagnosis, and treatment of patients with primary aldosteronism: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2008; 93(9):3266-81. doi: 10.1210/jc.2008-0104.
Rossi GP, Bernini G, Caliumi C, Desideri G, Fabris B, Ferri C, et al. A prospective study of the prevalence of primary aldosteronism in 1,125 hypertensive patients. J Am Coll Cardiol. 2006;48(11):2293-300. doi: 10.1016/j.jacc.2006.07.059.
Mulatero P, Sechi LA, Williams TA, Lenders JWM, Reincke M, Satoh F, et al. Subtype diagnosis, treatment, complications and outcomes of primary aldosteronism and future direction of research: a position statement and consensus of the Working Group on Endocrine Hypertension of the European Society of Hypertension. J Hypertens. 2020;38(10):1929-1936. doi: 10.1097/HJH.0000000000002520.
Reincke M, Bancos I, Mulatero P, Scholl UI, Stowasser M, Williams TA. Diagnosis and treatment of primary aldosteronism. Lancet Diabetes Endocrinol. 2021; 9(12):876-892. doi: 10.1016/S2213-8587(21)00210-2.
Rossi GP, Funder JW. Adrenal Venous Sampling Versus Computed Tomographic Scan to Determine Treatment in Primary Aldosteronism (The SPARTACUS Trial): A Critique. Hypertension. 2017;69(3):396-397. doi: 10.1161/HYPERTENSIONAHA.116.08820.
Williams TA, Burrello J, Sechi LA, Fardella CE, Matrozova J, Adolf C, et al. Computed Tomography and Adrenal Venous Sampling in the Diagnosis of Unilateral Primary Aldosteronism. Hypertension. 2018;72(3):641-649. doi: 10.1161/HYPERTENSIONAHA.118.11382.
Williams TA, Lenders JWM, Mulatero P, Burrello J, Rottenkolber M, Adolf C, 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(9):689-699. doi: 10.1016/S2213-8587(17)30135-3.
Descargas
Publicado
Versiones
- 2023-03-15 (2)
- 2022-12-30 (1)
Número
Sección
Licencia
Derechos de autor 2022 Interdisciplinary Journal of Epidemiology and Public Health

Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-SinDerivadas 4.0.
-
Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
-
NonCommercial — You may not use the material for commercial purposes.
-
NoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.