About hyperaldosteronism with hypokalemic alkatosis

What is hyperaldosteronism with hypokalemic alkatosis?

Bartter's syndrome (BS) is a group of conditions involving enlargement of certain kidney cells, blood that is more alkaline than normal, high levels of potassium and chloride in the urine, loss of potassium from the kidneys (renal potassium wasting), dehydration, muscle weakness, muscle cramps, frequent urination, and growth deficiency, potentially resulting in dwarfism. It is thought to be caused by a defect in the body's ability to reabsorb potassium. Individuals with Bartter syndrome have a disturbed acid-base ratio (i.e., an accumulation of base or loss of acid) associated with a loss of potassium (hypokalemic alkalosis). Low amounts of potassium may result from overproduction of a certain hormone (aldosterone) that is essential in controlling blood pressure and regulating sodium and potassium levels (hyperaldosteronism). Even so, the blood pressure of people with Bartter syndrome is normal.

What are the symptoms for hyperaldosteronism with hypokalemic alkatosis?

The main symptom of hyperaldosteronism is high blood pressure, which can range from moderate to severe. In some cases, high blood pressure related to hyperaldosteronism doesn’t respond to medication. In others, it may only respond to a certain combination of medications.

High blood pressure doesn’t typically have symptoms. But when it does, they can include:

  • headaches
  • dizziness
  • vision problems
  • chest pain
  • shortness of breath

The other main symptom of hyperaldosteronism is hypokalemia, which refers to low potassium levels in your blood. While it doesn’t always cause symptoms, more moderate cases of hypokalemia may cause:

  • fatigue
  • muscle cramps
  • increased thirst
  • increased urination
  • muscle weakness
  • palpitations

What are the causes for hyperaldosteronism with hypokalemic alkatosis?

There are two types of hyperaldosteronism, known as primary and secondary hyperaldosteronism. While they have similar symptoms, their causes are different.

Primary hyperaldosteronism

Primary hyperaldosteronism is caused by a problem with one or both adrenal glands. It’s sometimes referred to as Conn’s syndrome.

Some people are born with overactive adrenal glands. Others might have it due to:

  • a benign tumor on one of the adrenal glands
  • adrenocortical cancer, which is a rare aldosterone-producing cancerous tumor
  • glucocorticoid-remediable aldosteronism, a type of aldosteronism that runs in families
  • other types of inheritable issues that affect the adrenal glands

Secondary hyperaldosteronism

Secondary hyperaldosteronism is caused by something outside the adrenal glands. It’s usually related to reduced blood flow to your kidneys.

Several things can cause this, including:

  • a blockage or narrowing of the renal artery
  • chronic liver disease
  • heart failure
  • diuretic medications

What are the treatments for hyperaldosteronism with hypokalemic alkatosis?

Treating hyperaldosteronism focuses on reducing your aldosterone levels or blocking the effects of aldosterone, high blood pressure, and low blood potassium. There are several ways to do this, depending on what’s causing your hyperaldosteronism.


Your doctor might prescribe a mineralocorticoid receptor antagonist, such as spironolactone. This type of medication blocks the effects of aldosterone on your body, such as high blood pressure and low blood potassium. You may still need to take additional medications to help manage your blood pressure.


If you have a tumor on one of your adrenal glands, your doctor may be able to remove the affected gland. Following the procedure, called an adrenalectomy, you’ll likely notice a gradual decrease in blood pressure. As you heal, your doctor will regularly monitor your blood pressure to determine whether it’s time to change your blood pressure medication. Eventually, you may be able to stop taking it completely.

Lifestyle changes

In addition to medication and surgery, there are several lifestyle changes you can make to provide additional health benefits and help counteract the effects of too much aldosterone.

These include:

  • Eating a healthy diet. Following a balanced diet that helps you maintain a healthy weight can reduce your blood pressure. Start by choosing fresh, unprocessed foods to reduce your salt intake. Try incorporating elements of the DASH diet, which is designed for people with high blood pressure. In addition, many blood pressure medications work better when combined with a healthy diet. A diet lower in salt is often key in hyperaldosteronism.
  • Exercising. Consistent exercise, even just a 30-minute walk a few times a week, can help to reduce blood pressure.
  • Reducing alcohol and caffeine. Caffeine and alcohol can both increase your blood pressure. Some blood pressure medications are also less effective when taken with alcohol.
  • Quitting smoking. Smoking cigarettes constricts your blood vessels, which increases your heart rate and can raise blood pressure. Learn about different methods that can help you kick the habit. Smoking also increases your risk of heart attack and stroke, even without high blood pressure.

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