Reduced aldosterone production |
Hyporeninemic hypoaldosteronism |
Kidney disease, most often diabetic nephropathy |
Nonsteroidal antiinflammatory drugs |
Calcineurin inhibitors |
Volume expansion, as in acute glomerulonephritis |
Angiotensin inhibitors, such as ACE inhibitors, angiotensin II receptor blockers, and direct renin inhibitors |
Chronic heparin therapy (impairs aldosterone synthesis) |
Primary adrenal insufficiency |
Severe illness |
Inherited disorders |
Congenital hypoaldosteronism (21-hydroxylase deficiency and isolated hypoaldosteronism) |
Pseudohypoaldosteronism type 2 (Gordon's syndrome) |
Aldosterone resistance |
Inhibition of the epithelial sodium channel |
Potassium-sparing diuretics, such as spironolactone, eplerenone, amiloride, and triamterene |
Antibiotics, trimethoprim, and pentamidine |
Pseudohypoaldosteronism type 1 |
Voltage defects |
Markedly reduced distal sodium delivery |
Acquired or congenital defects in sodium reabsorption by the distal tubule principal cells (obstructive uropathy), SLE, and sickle cell disease |
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