Primary Hyperaldosteronism and Sodium Escape? - USMLE Forums
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Old 04-24-2012
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Kidney Primary Hyperaldosteronism and Sodium Escape?

What is the mechanism of sodium escape in primary hyperaldosteronism?
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Old 04-24-2012
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Sodium escape phenomenon in Primary Hyperaldosteronism (pituitary adenoma releasing high levels of aldosterone) -

Initially you get high levels of Na+ due to Na+ & H2O retention which increases intravascular volume of water. This increase in volume is sensed by the atria and it releases ANP which decreases Na+ reabsorption and there is also decreased renin & decreased proximal tubular reabsorption of Na+ ... this is called Na+ Escape and thats why you don't get edema in Hyperaldosteronism.

In secondary hyperaldosteronism, there is low BP or renal artery stenosis, so high levels of renin lead to high levels of aldosterone and no ANP is released. And aldosterone levels (and renin) are only elevated till the BP is back to normal. And when it can't get back to normal they remain elevated and keep retaining fluids and Na+ and lead to edema.
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Cardiovascular-, Endocrine-, Pathology-, Physiology-, Renal-

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