USMLE Forums banner

1 - 7 of 7 Posts

·
Registered
Joined
·
32 Posts
Yes Reninomas

Dear Laithbv,
I heard about reninomas from kaplan endocrinology videos of 2002 by charles faesilis and he liked to relate them with bartter's syndrome and gitelman's syndrome which affect loop of henle and distal tubules subseqently and are characterized by excessive loss of NaCl which leads to excess renin secretion.

Hope I helped
Good Luck
 

·
Registered
Joined
·
32 Posts
You need to understand the RAA axis and you can answer all related questions.
Low volume state --> Renin --> Angiotensin --> Aldosterone

If the beginning of the problem is Aldosterone (primary hyperaldosteronism) then you will have low renin by negative feedback.

If the beginning of the problem is low volume state (secondary hyperaldosteronism) then your renin will be high.

That UW question can easily be answered following the sequence above.

Causes of secondary hyperaldosteronism include:

  • Renovascular hypertension - renal artery stenosis
  • Low volume states (congested liver in heart failure is an example)
  • Reninomas which secrete renin autonomously from the JG apparatus
 

·
Registered
Joined
·
34 Posts
The idea now is :
1) you have increased renin which in turn increase the aldosterone so now you have both increased renin and aldosterone which is called 2ry hyperaldosteronism
2 ) DD :
1ry hyperaldosteronism ( with low renin) :
adrenal adenoma ( conns syndrome ) , hyperplasia , Glucocort icoid mediated
2ry hyperaldosteronism( with high renin):
renin secrating tumour, Renal artery stenosis , Cirrhosis , Hf , CRF , Chronic laxatives use , Hypothyroidism
 

·
Registered
Joined
·
37 Posts
The idea now is :
1) you have increased renin which in turn increase the aldosterone so now you have both increased renin and aldosterone which is called 2ry hyperaldosteronism
2 ) DD :
1ry hyperaldosteronism ( with low renin) :
adrenal adenoma ( conns syndrome ) , hyperplasia , Glucocort icoid mediated
2ry hyperaldosteronism( with high renin):
renin secrating tumour, Renal artery stenosis , Cirrhosis , Hf , CRF , Chronic laxatives use , Hypothyroidism
glucocorticoid mediated primary hyperaldosteronism? mechanism?:confused:
 

·
Registered
Joined
·
662 Posts
Causes of secondary hyperaldosteronism include:

  • Renovascular hypertension - renal artery stenosis
  • Low volume states (congested liver in heart failure is an example)
  • Reninomas which secrete renin autonomously from the JG apparatus
How can I tell the difference between a reninoma from renovascular hypertension just by labs??? both have high renin, HT... :confused::confused::confused:
 
1 - 7 of 7 Posts
Top