patmedfarПациентоориентированная медицина и фармацияPatient-Oriented Medicine and Pharmacy2949-1924LLC Izdatelstvo OKI10.37489/2949-1924-0142TONXHZpatmedfar-237Research ArticleУРОЛОГИЯ И АНДРОЛОГИЯUROLOGY AND ANDROLOGYПервичный гиперальдостеронизм (синдром Конна): клинический случай в практике нефрологаPrimary aldosteronism (Conn`s syndrome): a clinical case in nephrology practicehttps://orcid.org/0000-0002-2062-0421ШормановИ. С.ShormanovI. S.

Шорманов Игорь Сергеевич - д. м. н., профессор, зав. кафедрой урологии с нефрологией

Ярославль

Igor S. Shormanov - Dr. Sci. (Med.), Professor, Head of the Department of Urology and Nephrology

Yaroslavl 

i-s-shormanov@yandex.ruhttps://orcid.org/0000-0003-2464-572XЖигаловС. А.ZhigalovS. A.

Жигалов Сергей Алексеевич - к. м. н., доцент кафедры урологии с нефрологией

Ярославль

Sergey A. Zhigalov - Cand. Sci. (Med.), Associate Professor, Department of Urology and Nephrology

Yaroslavl 

sergey.zhigalow@gmail.comБажинаО. В.BazhinaO. V.

Бажина Ольга Викторовна - к. м. н., доцент кафедры урологии с нефрологией

Ярославль

Olga V. Bazhina - Cand. Sci. (Med.), Associate Professor, Department of Urology and Nephrology

Yaroslavl 

mascot212@mail.ruФГБОУ ВО «Ярославский государственный медицинский университет»РоссияYaroslavl State Medical UniversityRussian Federation202630062026428286Copyright © Шорманов И.С., Жигалов С.А., Бажина О.В., 20262026Шорманов И.С., Жигалов С.А., Бажина О.В.Shormanov I.S., Zhigalov S.A., Bazhina O.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.pomph.ru/jour/article/view/237

В статье представлен клинический случай пациента 34 лет с длительной артериальной гипертензией, дебютировавшей в подростковом возрасте, и стойкой гипокалиемией, сохранявшейся на протяжении нескольких лет. Несмотря на комбинированную антигипертензивную терапию (амлодипин, телмисартан, индапамид), достичь целевого уровня артериального давления не удавалось. При лабораторном обследовании выявлены супрессия ренина плазмы (0,5–0,8 мкЕд/мл), повышенный уровень альдостерона (до 29 нг/дл) и значительное увеличение соотношения альдостерон/ренин (ARR >50). Проба с каптоприлом подтвердила автономную секрецию альдостерона. При компьютерной томографии надпочечников обнаружено образование левого надпочечника размером 20 × 14 мм, характерное для аденомы. После выполнения односторонней адреналэктомии у пациента отмечены нормализация артериального давления (без приёма гипотензивных препаратов), восстановление уровня калия в сыворотке крови и улучшение почечных показателей, включая снижение альбумин-креатининового соотношения. Данный случай демонстрирует необходимость активного скрининга первичного гиперальдостеронизма у молодых пациентов с резистентной гипертензией и гипокалиемией, а также подчёркивает возможность полного излечения заболевания при своевременном хирургическом вмешательстве.

We present a clinical case of a 34-year-old male patient with a long-standing history of arterial hypertension dating back to adolescence, accompanied by persistent hypokalemia and poor response to standard antihypertensive therapy. Despite combination treatment with amlodipine, telmisartan, and indapamide, target blood pressure levels were not achieved, and hypokalemia (2.7–3.3 mmol/L) persisted over several years. Laboratory evaluation revealed suppressed plasma renin activity (0.5–0.8 µIU/mL) and elevated aldosterone levels (up to 29 ng/dL), with a markedly increased aldosterone-to-renin ratio (ARR > 50). A captopril suppression test confirmed autonomous aldosterone secretion, and abdominal CT identified a 20×14 mm adrenal adenoma in the left adrenal gland. The patient underwent unilateral adrenalectomy, which resulted in normalization of blood pressure without antihypertensive medications, correction of serum potassium levels, and improvement in renal parameters, including a reduction in the albumin-to-creatinine ratio. This case underscores the importance of early screening for primary aldosteronism in young hypertensive patients with resistant hypertension and hypokalemia, and highlights the potential for complete cure through timely surgical intervention.

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The authors declare that there are no conflicts of interest present.