In primary hyperaldosteronism, which statement best describes fluid status?

In primary hyperaldosteronism, which statement best describes fluid status?

• A. They are volume expanded but not edematous
• B. They have significant edema
• C. They are hypovolemic
• D. They have hypoalbuminemia causing edema

Answer: (A)

Primary hyperaldosteronism drives sodium and water retention, which expands the extracellular fluid volume and raises blood pressure. At the same time, edema is not a typical feature because the expanded intravascular volume does not usually translate into interstitial fluid accumulation; mechanisms like aldosterone escape help prevent edema and maintain a relatively euvolemic state outside of mild volume expansion. So the fluid status is best described as volume expanded but not edematous. Edema would point more toward hypoalbuminemia, liver/kidney failure, or heart failure, where interstitial fluid accumulation occurs. Hypovolemia is unlikely because sodium retention is the hallmark.

Primary hyperaldosteronism drives sodium and water retention, which expands the extracellular fluid volume and raises blood pressure. At the same time, edema is not a typical feature because the expanded intravascular volume does not usually translate into interstitial fluid accumulation; mechanisms like aldosterone escape help prevent edema and maintain a relatively euvolemic state outside of mild volume expansion. So the fluid status is best described as volume expanded but not edematous. Edema would point more toward hypoalbuminemia, liver/kidney failure, or heart failure, where interstitial fluid accumulation occurs. Hypovolemia is unlikely because sodium retention is the hallmark.