Stimulation and Suppression of Aldosterone Secretion in Patients with an Aldosterone-Producing Adenoma12

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Abstract
Maneuvers designed to stimulate or suppress aldosterone secretion were carried out in 22 patients with an aldosterone-producing adenoma while on a constant metabolic diet. Administration of angiotensin stimulated aldosterone excretion in only 3 of 12 patients but an increased pressor responsiveness limited the dose which could be given. Administration of desoxycorticosterone did not suppress aldosterone excretion (18/18) and sodium restriction did not stimulate aldosterone excretion (13/13) in any of the patients studied. Phlebotomy and plasma expansion did not consistently influence aldosterone excretion. Potassium repletion and administration of adrenocorticotropin stimulated aldosterone production significantly in most of the patients. Administration of dexamethasone suppressed aldosterone production in 6 of 14 patients. Following removal of the adenoma aldosterone excretion fell to subnormal levels and did not respond to stimulation with adrenocorticotropin, sodium restriction or angiotensin. Aldosterone-producing adenomas generally are not affected by maneuvers acting via the reninangiotensin system during short periods of stimulation. Potassium balance and adrenocorticotropin have important regulatory roles in the production of aldosterone by these tumors.

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