Update

[Guest guest]

Briefly, my adrenal history includes a right adenoma dx'd in 2000 and a left

adenoma dx'd in 2009 and drug-resistant HTN for 25 years. My right renal artery

is 70% stenosed (US dx) and the right kidney is atrophic. I had some basic lab

work done 2 weeks ago. Aldosterone was 25 (high). Renin 9.3 (high normal).

Started Spiro 25mg daily after labs were drawn. I have been on the Spiro for 2

weeks now. After one dose, the brain fog lifted, my lungs were much more clear,

the trace LE peripheral edema started to diminish and my blood pressure began to

decrease.

The second week on Spiro, I felt generally horrible and my BPs were improving

but not good. At the end of the second week, BP normalizing and K+ maintained on

20mEq BID (had been taking 40 BID and supplementing when the low K+ PVCs cycled

in - usually 160mEq over 24 hrs). The sum: I am feeling much better.

I was referred to endo. Saw him today. Super doc with a great big brain. He says

there is so much going on with me, now and historically, he is not sure if it is

primary or secondary aldosteronism because of the renal artery stenosis or the

long-term NSAID therapy (800mg BID for the issues with my lumbar vertebrae and

left hip). Based on the numbers and diagnostics, he is leaning toward secondary.

He ordered labs to check for Pheo, Cushing's, etc., and I will see him in one

month. He also wants a repeat CT because the last one was 3 years ago. I won't

do that until Medicare kicks in July 1. He's okay with that.

He said it was up to me if I wanted to purge the drugs, do a salt loading and

then retest. He also said he would refer me to a university setting for an AVS

if I wanted a definitive diagnosis. The way I view it... I am 65, retired, and

Spiro is working. Kind of a no brainer.

Any thoughts?

Barb