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Medicina & Laboratorio

2012, Número 05-06

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Medicina & Laboratorio 2012; 18 (05-06)


Hiperaldosteronismo primario: el gran olvidado en pacientes con hipertensión de inicio temprano y de difícil control, enfoque y manejo

Alzate MDC, Vásquez MM

Idioma: Español
Referencias bibliográficas: 63
Paginas: 211-227
Archivo PDF: 848.59 Kb.


RESUMEN

el hiperaldosteronismo primario es una enfermedad que se caracteriza por la producción autónoma en exceso de aldosterona, que tiene como resultado la supresión de los niveles de renina, causando con frecuencia hipertensión arterial e hipokalemia. El hiperaldosteronismo primario es más común de lo que se pensaba. La alta prevalencia, el daño que causa al sistema cardiovascular y a los riñones, y el hecho de que un diagnóstico y tratamiento oportunos puedan corregir la hipertensión y la hipokalemia, justifican la búsqueda del hiperaldosteronismo primario en muchos pacientes con hipertensión. Cuando se sospecha hiperaldosteronismo primario, se deben realizar pruebas de tamización; la prueba de elección es la relación entre la concentración de aldosterona plasmática y la actividad de la renina plasmática. Posteriormente, se debe confirmar el diagnóstico con alguno de los métodos disponibles, como la carga oral de sodio o la prueba de infusión de solución salina, entre otros. Una vez se confirma el diagnóstico, el paso a seguir es determinar el subtipo de hiperaldosteronismo primario, lo cual es importante para determinar el tratamiento más adecuado. Finalmente, se deben hacer estudios de imaginología para identificar posibles lesiones en las glándulas adrenales.


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