Primary and Secondary Hyperaldosteronism

Feature

Primary Hyperaldosteronism
(Conn’s syndrome)

Secondary Hyperaldosteronism

Definition

Autonomous overproduction of
aldosterone by the adrenal gland.

Overproduction of aldosterone due to
activation of RAAS.

Common
Causes

- Aldosterone producing adenoma
(Conn’s syndrome)

- Bilateral adrenal hyperplasia

- Renal artery stenosis

- Congestive heart failure

- Cirrhosis

- Nephrotic syndrome

Plasma
Aldosterone

Elevated

Elevated

Plasma
Renin

Suppressed (low)

Elevated (High)

Aldosterone-to-
Renin Ratio

High

Normal or low

Potassium
Levels

Decreased (hypokalemia)

Decreased (hypokalemia)

Acid-Base
Status

Metabolic alkalosis

Metabolic alkalosis