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In medicine (endocrinology), hypoaldosteronism refers to decreased levels of the hormone aldosterone.
There are several causes for this condition, including primary adrenal insufficiency, congenital adrenal hyperplasia, and medications (certain diuretics, NSAIDs, and ACE inhibitors).
This condition may result in hyperkalemia, when it is sometimes termed ‘type 4 renal tubular acidosis’ even though it doesn’t actually cause acidosis. It can also cause urinary sodium wasting, leading to volume depletion and hypotension.
Na+ is lost in the urine. K+ is retained, and the plasma K+ rises. When adrenal insufficiency develops rapidly, the amount of Na+ lost from the ECF exceeds the amount excreted in the urine, indicating that Na+ also must be entering cells. When the posterior pituitary is intact, salt loss exceeds water loss, and the plasma Na+ falls. However, the plasma volume also is reduced, resulting in hypotension, circulatory insufficiency, and, eventually, fatal shock. These changes can be prevented to a degree by increasing the dietary NaCl intake. Rats survive indefinitely on extra salt alone, but in dogs and most humans, the amount of supplementary salt needed is so large that it is almost impossible to prevent eventual collapse and death unless mineralocorticoid treatment is also instituted
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