aldoszterontermeléscsökkenéssel

Aldosterone is a steroid hormone produced by the adrenal cortex, responsible for regulating sodium and potassium balance as well as blood pressure. When aldosterone production decreases—known clinically as hypoaldosteronism—the body’s ability to retain sodium and excrete potassium is impaired.

Causes of decreased aldosterone production are varied. Congenital adrenal hyperplasia, particularly 11‑β‑hydroxylase or 17‑α‑hydroxylase deficiencies, can lead to insufficient aldosterone. Adrenal vein sampling or imaging may reveal adrenal atrophy or bilateral adrenal insufficiency as underlying reasons. Autoimmune destruction of adrenal cortex, infiltrative diseases such as sarcoidosis, or iatrogenic suppression from exogenous steroids can also diminish aldosterone output. Additionally, mutations in the mineralocorticoid receptor or in genes coding for the renin–angiotensin system may indirectly affect aldosterone synthesis.

Typical symptoms include low blood pressure, dizziness upon standing, weakness, and electrolyte disturbances such as hyponatremia and hyperkalemia. Patients may also present with dehydration or, in severe cases, an adrenal crisis. Diagnosis involves measuring plasma renin activity, serum aldosterone concentration, and calculating the aldosterone‑to‑renin ratio. Further confirmatory tests include saline infusion, oral sodium loading, or fludrocortisone suppression.

Treatment focuses on correcting electrolyte imbalances and replacing deficient hormone. Low-dose fludrocortisone, mineralocorticoid therapy, or in some cases high-dose potassium‑sequestering agents are used to restore sodium retention and potassium excretion. Regular monitoring of blood pressure, serum electrolytes, and renal function is essential to adjust therapy and prevent complications.