COMPLEX HYDROELECTROLYTIC DISTURBANCES IN PATIENTS WITH PRIMARY ALDOSTERONISM
DOI:
https://doi.org/10.56238/levv17n56-039Keywords:
Primary Aldosteronism, Electrolyte Disorders, Hypokalemia, Hypomagnesemia, Metabolic AlkalosisAbstract
Introduction: Primary aldosteronism is a common cause of secondary hypertension and is characterized by autonomous aldosterone secretion. Although classically associated with hypokalemia, increasing evidence suggests that this condition may present with complex and clinically significant hydroelectrolytic disturbances. Objective: To systematically review the literature on complex hydroelectrolytic disturbances described in patients with primary aldosteronism, focusing on clinical presentation, underlying mechanisms, and diagnostic implications. Methods: A systematized literature review was conducted using the PubMed database. Studies describing hydroelectrolytic and/or acid–base disturbances in patients with primary aldosteronism were included, without restrictions on study design. Extracted data included clinical characteristics, diagnostic criteria, electrolyte and acid–base profiles, associated complications, therapeutic interventions, and clinical outcomes. Results: Fifteen studies met the inclusion criteria, predominantly case reports and small case series. Hypokalemia was the most frequently reported disturbance, often severe, refractory to supplementation, and associated with metabolic alkalosis. Hypomagnesemia, calcium metabolism disorders, and hypercalciuria were also described. Serious complications such as rhabdomyolysis, hypokalemic periodic paralysis, and ventricular arrhythmias were reported as initial or associated manifestations. Targeted treatment of aldosterone excess resulted in progressive normalization of electrolyte abnormalities. Conclusion: Primary aldosteronism may present with complex and potentially severe hydroelectrolytic disturbances. Recognition of these presentations is essential for early diagnosis and appropriate treatment, with direct impact on morbidity reduction.
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References
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