II. Definitions

  1. Aldosterone
    1. Aldosterone is a key Mineralocorticoid that triggers renal retention of Sodium (and water) and Potassium excretion
    2. Steroid Hormone synthesized in the zona glomerulosa of the Adrenal Cortex, with release triggered by Angiotensin 2
  2. Mineralocorticoid
    1. Class of Corticosteroids regulating Sodium and Water Homeostasis, primarily the retention of Sodium (and water)
    2. Aldosterone is the key Mineralocorticoid (although agents have Mineralocorticoid activity such as Progesterone)
    3. Fludrocortisone (Florinef) is a synthetic agent with Mineralocorticoid activity

III. Physiology

  1. See Sodium and Water Homeostasis
  2. Aldosterone is a key Mineralocorticoid
    1. Triggers renal retention of Sodium (and water)
    2. Ions exchanged for Sodium ion retention
      1. Potassium (increased Potassium excretion)
      2. Hydrogen Ion (alkalosis)
  3. Aldosterone is a steroid Hormone synthesized in the zona glomerulosa of the Adrenal Cortex
    1. Aldosterone levels represent only 1% of Glucocorticoid levels (esp. Cortisol)
  4. Modifying factors
    1. Release is stimulated primarily by Angiotensin 2, but also by ACTH and Hyperkalemia
    2. Atrial natriuretic factor inhibits Aldosterone release
  5. Mineralocorticoids are inactivated by 11-beta hydroxysteroid dehydrogenase 2
    1. Chronic Licorice intake inhibits this enzyme and may result in secondary Hyperaldosteronism

IV. Pathophysiology

V. Labs

  1. Typically measured with plasma renin activity (PRA) to obtain a morning Aldosterone to PRA ratio
    1. See Hyperaldosteronism
  2. Serum Aldosterone (radioimmunoassay)
    1. Normal Morning level in resting, seated adults: 5 to 30 ng/dl (140 to 830 pmol/L)
  3. Miscellaneous effects on levels
    1. Lower levels in black patients
    2. Levels are highest in the morning and lowest in evening

VI. Causes: Increased Serum Aldosterone

  1. See Hyperaldosteronism
  2. Primary Aldosteronism
  3. Secondary Hyperaldosteronism
    1. Renal Artery Stenosis
    2. Malignant Hypertension
    3. Edematous States with intravascular volume depletion (e.g. Heart Failure, Cirrhosis)
    4. Medications (Aldosterone Antagonists, Progesterone)
  4. Hyperkalemia
  5. Women in Luteal Phase of Menstrual Cycle
  6. Pregnancy
    1. Levels may be 10 fold higher in third trimester than in non-pregnant patients
  7. High licorice consumption

VII. Causes: Decreased Serum Aldosterone

  1. 11-beta Hydroxylase deficiency
  2. 17-alpha-hydroxylase deficiency
  3. Cushing Syndrome
  4. Primary Adrenal Insufficiency
  5. Liddle's Syndrome
  6. Diabetic Nephropathy
  7. Ectopic ACTH Syndrome

VIII. Resources

IX. References

  1. Stowasser in Lacroix (2021) Assays of Renin-Angiotensin-Aldosterone system in adrenal disease, UpToDate, accessed 2/26/2022

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Related Studies

Ontology: Aldosterone (C0002006)

Definition (CHV) a hormone that controls electrolyte and water balance
Definition (NCI_NCI-GLOSS) A steroid hormone made by the adrenal cortex (the outer layer of the adrenal gland). It helps control the balance of water and salts in the kidney by keeping sodium in and releasing potassium from the body. Too much aldosterone can cause high blood pressure and a build-up of fluid in body tissues. Aldosterone is a type of mineralocorticoid hormone.
Definition (NCI) A hormone secreted by the adrenal cortex that regulates electrolyte and water balance by increasing the renal retention of sodium and the excretion of potassium. (MeSH)
Definition (MSH) A hormone secreted by the ADRENAL CORTEX that regulates electrolyte and water balance by increasing the renal retention of sodium and the excretion of potassium.
Definition (CSP) hormone secreted by the adrenal cortex that regulates electrolyte and water balance by increasing the renal retention of sodium and the excretion of potassium.
Concepts Pharmacologic Substance (T121) , Hormone (T125) , Steroid (T110)
MSH D000450
SnomedCT 42605004, 22474002
LNC LP14377-3, MTHU004471
English Aldosterone, Pregn-4-en-18-al, 11,21-dihydroxy-3,20-dioxo-, (11beta)-, Aldosterone [Chemical/Ingredient], ALDOSTERONE, aldosterone, (+)-Aldosterone, Aldosterone preparation, Aldosterone (substance), Aldosterone preparation (product), Aldosterone preparation (substance)
Swedish Aldosteron
Czech aldosteron
Finnish Aldosteroni
Russian AL'DOSTERON, АЛЬДОСТЕРОН
Japanese アルドステロン, エレクトロコルチン
Spanish aldosterona (producto), preparado con aldosterona (producto), preparado con aldosterona, aldosterona (sustancia), aldosterona, preparado de aldosterona (producto), preparado de aldosterona (sustancia), preparado de aldosterona, Aldosterona
Croatian ALDOSTERON
Polish Aldosteron, Elektrokortyna
Norwegian Aldosteron
French Aldostérone
German Aldosteron
Italian Aldosterone
Portuguese Aldosterona

Ontology: Mineralocorticoids (C0026160)

Definition (MSH) A group of CORTICOSTEROIDS primarily associated with water and electrolyte balance. This is accomplished through the effect on ION TRANSPORT in renal tubules, resulting in retention of sodium and loss of potassium. Mineralocorticoid secretion is itself regulated by PLASMA VOLUME, serum potassium, and ANGIOTENSIN II.
Definition (NCI) A class of corticosteroid hormones that maintains fluid and electrolyte balance. The main mineralocorticoid is Aldosterone.
Definition (CSP) hormones secreted by the adrenal cortex that maintain normal blood volume, promote sodium and water retention and increase urinary excretion of potassium and hydrogen ions.
Concepts Hormone (T125) , Steroid (T110) , Pharmacologic Substance (T121)
MSH D008901
SnomedCT 36887008, 83692001
English Mineralocorticoids, MINERALOCORTICOIDS, mineralocorticoids, mineralocorticoids (medication), [HS052] MINERALOCORTICOIDS, mineralocorticosteroids, mineralocorticosteroid, mineralocorticoid, Mineralocorticoid hormone, Mineralocorticoid hormone (substance), Mineralocorticoid preparation (product), Mineralocorticoid preparation, Mineralocorticoid preparation, NOS, Mineralocorticoid preparation (substance), Mineralocorticoid
Swedish Mineralkortikoider
Czech mineralokortikoidy
Finnish Mineralokortikoidit
Russian MINERALOKORTIKOIDY SINTETICHESKIE, MINERALOKORTIKOIDY, MINERALOKORTIKOIDOV ANALOGI, MINERALOKORTIKOIDNOE DEISTVIE, МИНЕРАЛОКОРТИКОИДНОЕ ДЕЙСТВИЕ, МИНЕРАЛОКОРТИКОИДОВ АНАЛОГИ, МИНЕРАЛОКОРТИКОИДЫ, МИНЕРАЛОКОРТИКОИДЫ СИНТЕТИЧЕСКИЕ
Spanish preparado con mineralocorticoide (producto), mineralocorticoide, mineralocorticoide (producto), preparado con mineralocorticoide, Efecto Mineralocorticoide, hormona mineralocorticoide (sustancia), hormona mineralocorticoide, preparado de mineralocorticoides (producto), preparado de mineralocorticoides (sustancia), preparado de mineralocorticoides, Mineralocorticoides
Polish Mineralokortykoidy
Portuguese Mineralocorticoides, Efeito Mineralocorticoide
French Minéralocorticoïdes
German Mineralocorticoide
Italian Corticoidi minerali