Anatomy And Physiology

Anatomy Physiology

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According to “Mosby’s Medical, Nursing and Allied Health” dictionary (1990):    Aldosterone is a steroid hormone produced by the adrenal cortex to regulate sodium and potassium balance in the blood. The adrenal cortex is the greater portion of the adrenal gland, located on the top of each kidney.

Role of Aldosterone:

Aldosterone is one of the hormones belonging to the class called mineral corticolds. It has the critical role of helping to regulate blood pressure and also the water and potassium balance in the body, by helping the kidneys retain sodium and excreting excess potassium. When the aldosterone level is low, the kidneys fail to keep this balance which leads to a drop in both the blood volume and blood pressure.

Body system involved:

It is a part of the Renin-Angiotensin-Aldosterone System. The kidney hormone renin stimulates the adrenal glands to release aldosterone. An over active adrenal gland will lead to high blood pressure and/or low potassium levels. This level can be measured by a blood test.

Blood test for aldosterone:

When preparing for this test, there are specific preparations you must follow. For two weeks prior, do not eat salty foods, but you must not follow an extreme low salt diet either as this will affect the test results. A normal salt intake is 2,300 mg per day.

Let your doctor know what medicines you are on, including over the counter medicines. There are medications that may have to be stopped:

Hormones such as:
•  progesterone
•  estrogen
•  corticosteroids
•  diuretics

High blood pressure medications
•  spironolactone (Aldactone)
•  eplerenone (Inspra)
•  beta-blockers

Test results:

The results of the tests can also be altered by your body position when the blood is taken. Standing, sitting or lying down will give different results. The doctor may request that the blood be drawn in more than one position if the results are abnormal, to make sure the results are accurate. The time of day also affects the level of aldosterone. Early morning often means a higher level will be noted. Normal results for adults sitting or standing are: 7-30 ng/dL, (nanograms per deciliter), 0.19-0.83 nmol/L (nanomoles per liter) When lying down the results are lower: 3-16 ng/dL or 0.08-0.44 nmol/L

When there is an overgrowth of normal cells in the adrenal gland (adrenal hyperplasia) it is called primary aldosteronism. Certain diseases can cause this also, such as; heart failure cirrhosis, or kidney disease. These diseases cause secondary aldosteronism. With secondary aldosteronism, the renin is also high. It is renin that controls how much aldosterone is released. Aldosterone can also be measured by a 24 hour urine test.

Treatment for abnormal aldosterone:

If the abnormal aldosterone is caused by an adenoma (tumor), its removal will usually cure the problem. Up to 60 percent of the cases are caused by an adenoma.

There are medications that can help manage hyperaldosteronism such as the well-known choice, spironlactone, but those with kidney disease cannot take this. The hypertension can be controlled with various medications. Diuretics also help control hypertension, but then the individual must be aware of replacing the potassium that is removed by the diuretics.

There is also the option of trying to control hypertension through diet, stress reduction (by means of massage, meditation, biofeedback and yoga). This means adopting a whole new lifestyle that is not easy for some people, but with persistence it pays off. Aldosterone does play a critical role when it comes to good health. An awareness of how excessive diet consumption and lifestyle must be addressed on a regular basis by all who wish to avoid the results of not doing so. For some, there is no choice, so awareness is again important in regard to catching aldosterone abnormalities early for quick treatment and higher success rates.

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