Loss by kidney: (1) diseases related to mineralocorticoid increases mainly include adrenocortical tumor or hyperplasia, juxtaglomerular cell tumor, ectopic aldosterone-producing tumor, Cushing syndrome, and pseudohyperaldosteronism
can be caused by overconsumption of Glycyrrhiza glabra (licorice) because glycyrrhizin inhibits 11-beta hydroxysteroid dehydrogenase thus preventing Cortisol's inactivation to cortisone in the kidney and thereby potentiating the mineralocoricoid effect of endogenous Cortisol.
presents with low aldosterone and low renin and may result from genetic or acquired etiologies.
8) Fluoroprednisolone and 9[alpha]-fluorocortisol have considerable direct mineralocorticoid activity; in large amounts they produce arterial hypertension with a clinical picture of pseudohyperaldosteronism
(increased exchangeable sodium and blood volume, hypokalemic metabolic alkalosis, and suppressed plasma renin and aldosterone levels).
However, there exists a sensitive subset of the population who appears to show signs of pseudohyperaldosteronism
at lower exposures than those which produce effects in the general population.
Promoted as expectorant and digestive aid, licorice is a potent inhibitor of an enzyme in corticosteroid metabolism, so a pseudohyperaldosteronism
can result after 4 or more weeks of use.
This results in pseudohyperaldosteronism
with sodium and fluid retention, metabolic alkalosis, inhibition of the renin-angiotensin system, and hypertension.