Clinical feature: 

Definition: Pseudohypoaldosteronism type 1 is a salt wasting disorder with elevated plasma aldosterone and renin levels. Inheritance may be autosomal recessive or dominant.

Pathogenesis: The main pathogenetic mechanisms are salt wasting and unresponsiveness to aldosterone. Disturbances in two molecular structures are responsible for the disease, the aldosterone-sensitive sodium channel, which is coded by three different genes, and the mineralocorticoid receptor.

Clinical picture: As all types of pseudohypoaldosteronism metabolic acidosis and hyperkalemia are present. Additionally, elevated levels of renin and aldosterone are mandatory. Blood pressure is rather low. Dependent on what molecular structure is altered, autosomal recessive (aldosteronsensitive sodium channel) or dominant (mineralocorticoid receptor) inheritance ensues.
Therapy consists of life-long salt supplementation in cases due to non-functioning sodium channel. Cases with mineralocorticoid receptor mutation tend to remission in adulthood.

Diagnostics: 

Diagnosis: The diagnosis of pseudohypoaldosteronism type 1 is likely when metabolic acidosis, and hyperkalemia are associated with elevated levels of aldosterone and renin. Additional findings are hypochloremia, hyponatremia, and a rather low blood pressure.
The type of inheritance is often difficult to determine, for most cases are spontaneous.

Differential: Type 1 of pseudohypoaldosteronism differs from type 2 in respect of hypotensive blood pressure and more elevated renin and aldosterone levels.  » » » 

Literature: 

Luft FC et al. (2003) Mendelian forms of human hypertension and mechanisms of disease.
Geller DS et al. (2005) Mineralocorticoid resistance.