Excess Secretion and Volume & Electrolyte Imbalance

• Excess Secretion:
  Conditions mirroring high blood aldosterone (e.g., primary hyperaldosteronism) lead to increased urinary excretion.
• Volume and Electrolyte Imbalance:
  Persistent high urinary aldosterone may contribute to hypertension and hypokalemia.

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Low Aldosterone in Urine May Indicate:

• Adrenal Insufficiency (Addison’s Disease) – A condition where the adrenal glands fail to produce enough hormones.
• Hyporeninemic Hypoaldosteronism – Often seen in diabetes or chronic kidney disease, leading to low aldosterone and impaired sodium balance.
• Excessive Sodium Intake – High dietary sodium can suppress aldosterone production.

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Standard Reference Range Considerations

• Age Variability:
  Standard reference ranges can vary with age and even diurnal factors.
• Pediatric Considerations:
  In pediatric populations, values are interpreted considering both developmental stage and body size.

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Renin–Angiotensin–Aldosterone System (RAAS)

All these markers are components of the Renin–Angiotensin–Aldosterone System (RAAS), which regulates blood pressure, fluid balance, and electrolyte homeostasis:

• Renin is produced by the kidneys and initiates the process by converting angiotensinogen into angiotensin I.
• Angiotensin I serves as a precursor that is converted by Angiotensin Converting Enzyme (ACE) into the active Angiotensin II.
• Angiotensin II is a potent vasoconstrictor that also stimulates the adrenal cortex to secrete Aldosterone.
• Aldosterone, measured in both blood and urine, acts on the kidneys to enhance sodium and water retention, thereby increasing blood volume and pressure.

Together, these components work in a coordinated cascade to maintain cardiovascular stability and fluid balance.

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