Aldosterone is a mineralocorticoid hormone produced by the glomerular layer of the adrenal glands. Both too low a concentration of this hormone and above the upper limit of the normal range are abnormal and the causative agent should be identified to initiate appropriate diagnostic and therapeutic procedures.

Aldosteroneis primarily responsible for regulating the body's water and mineral balance, and more specifically the elimination of potassium ions from the body and the reabsorption of sodium ions. Thanks to this, it is possible to maintain normal blood pressure. The regulation of aldosterone secretion is based on a feedback mechanism and it is a component of the RAA - renin-angiotensin-aldosterone system. When blood pressure is lowered or the body becomes dehydrated, which is associated with abnormal sodium levels, the body begins to produce renin, an enzyme involved in the biochemical reaction as a catalyst. Thanks to its activity, angiotensin is produced, which stimulates the adrenal glands to secrete aldosterone. Thus, disturbances in this pathway at any stage may result in abnormal aldosterone levels.

Increased aldosterone levels

Abnormally high levels of aldosterone are called hyperaldosteronism. Symptoms that may indicate an elevated aldosterone level:

  • increased blood pressure values, increased thirst and passing more urine (polyuria) - symptoms of body fluid overload and the associated increased sodium concentration in the body
  • numbness and painful muscle spasms, weakness of the body, arrhythmias - a consequence of a reduced concentration of potassium

In addition to the increased concentration of aldosterone, there are situations in which the level of this substance is insufficient. Symptoms of the so-called of hypoaldosteronism is:

  • dehydration of the body with a simultaneous decrease in sodium concentration, which manifests itself as: weakening of the body and decreased blood pressure
  • increased potassium levels, which causes weakness and abnormal heart rhythm

Causes of high aldosterone levels

Hyperaldosteronism , orelevated aldosterone levelsresults from dehydration, narrowing of the renal artery, and heart failure, which impairs blood flow through the kidneys. Rarely the causeExcessive secretion of aldosterone is cirrhosis of the liver. In the case of insufficient liver, the production of albumin adequate to the demand does not take place. These are plasma proteins whose role is focused on the regulation of oncotic blood pressure. As a consequence of too little protein, the water eliminated from the blood vessels goes to the extracellular space, which causes dehydration of the cells. A failing liver is also unable to properly metabolize many substances, including aldosterone. Casuistically, the cause of hyperaldosteronism is given as tumors that secrete excessive amounts of renin.

Causes of low aldosterone levels

Reduced aldosterone levelsmay be due to kidney dysfunction, most often as a result of complicated diabetes. Kidneys that do not function properly begin to produce reduced amounts of renin, an activator of the renin-angiotensin-aldosterone pathway. Another factor that contributes to the described disorder is primary adrenal insufficiency, described in the literature as Addison's disease. Most often it results from an autoimmune reaction of the body, an inborn deficiency of enzymes responsible for the synthesis of adrenal hormones. Not infrequently, pharmacotherapy has a negative influence on the function of the renin-angiotensin-aldosterone system. Examples include angiotensin converting enzyme inhibitors or popular non-steroidal anti-inflammatory drugs.

When should the aldosterone concentration be determined?

In fact, the indications for the determination of the concentration of aldosterone are the conditions described above contained in the symptoms of excessive secretion of aldosterone or inadequate to the need. The list of situations that should force the patient to verify aldosterone levels include:

  • treatment-resistant severe hypertension
  • increased thirst and frequent urination of large portions of urine - in this case diabetes should be ruled out
  • weakness, numbness and painful muscle spasms, abnormal heart rhythm - due to abnormal potassium levels

You must talk to your doctor before performing the test. It should be made clear which factors may modify the final aldosterone level. These include diet used, medications taken, type of physical activity or a multitude of stressful situations. Body position is also important, therefore it is recommended that you stand for at least 15-20 minutes before blood sampling, and if possible, blood should be drawn before the patient gets out of bed, which is only to be done in a hospital setting.

As it wasmentioned above, in order to determine the level of aldosterone, it is necessary to take a blood sample, or it is allowed to test from the daily urine collection, started in the morning after a good night's sleep.

Aldosteron: norms

The correct result for the determination of plasma aldosterone concentration is 140-560 pmol / l (5-20 ng / dl), while for the 24-hour urine collection is 14-53 nmol / 24 h (5-19 ug / 24 h) . The obtained result should be consulted with a doctor and discussed individually. The result modifies: age, sex, stress, sodium and potassium supplementation in the diet or the general condition of the patient.

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