Pharmacological Strategies for Managing Hyperaldosteronism in Children: Current Insights

Abstract

Hyperaldosteronism in children, characterized by excessive production of the hormone aldosterone, can lead to significant clinical challenges, including hypertension and electrolyte imbalances. The management of this condition often involves pharmacological strategies aimed at reducing aldosterone levels and mitigating its effects on the body. Mineralocorticoid receptor antagonists, such as spironolactone and eplerenone, are commonly used to block the action of aldosterone, thereby promoting sodium excretion and potassium retention. These medications can effectively lower blood pressure and improve metabolic profiles in affected children. Additionally, the use of angiotensin-converting enzyme (ACE) inhibitors may provide further benefit by inhibiting the renin-angiotensin-aldosterone system (RAAS), which is often overactive in hyperaldosteronism. In more complex cases, particularly those associated with adrenal adenomas or bilateral adrenal hyperplasia, surgical intervention may be necessary, but pharmacological management remains a cornerstone of treatment. Ongoing research is focusing on the long-term effects of these therapies, including potential impacts on growth and development in pediatric populations. Furthermore, individualized treatment plans that consider the child's age, weight, and comorbid conditions are essential for optimizing outcomes. Regular monitoring of blood pressure, serum electrolytes, and renal function is crucial in managing hyperaldosteronism effectively in children, ensuring that any adverse effects of medications are promptly addressed.

Keywords

• Hyperaldosteronism, children, pharmacological management, mineralocorticoid receptor antagonists, spironolactone, eplerenone, ACE inhibitors, renin-angiotensin-aldosterone system, adrenal adenomas, bilateral adrenal hyperplasia, individualized treatment, monitoring, hypertension, electrolyte imbalances.