Adrenal Gland Disorders
The adrenal glands are located in the upper pole of both kidneys and produce hormones that are not related to the kidney functions. Their dimensions are approx. 30x50x10mm and they usually weigh about 4-5g. The adrenal glands consist of two layers called the cortex and medulla and the cortex produces cortisol, aldosterone, androgens, and estrogen, while the medulla secretes adrenaline and noradrenaline.
The main metabolic functions of cortisol are anti-inflammatory and immunosuppressive effects, management of the blood pressure, decrease of the bone formation, increase of the insulin resistance (diabetogenic effect), lipolysis, and proteolysis. The excessive release of cortisol may depend on cerebellum-mediated, ectopic or direct adrenal hyperplasia, adenoma or cancer. As a result, Cushing’s disease is developed. Weight gain, abdominal obesity, round face, increased fat around the base of the neck, and stretch marks on the abdomen are typical findings.
The excessive production of aldosterone may lead to hypertension and a decrease in potassium levels in blood. This clinical condition is called Conn’s syndrome. The overactivity of the medullary layer of the adrenal gland causes the clinical condition called pheochromocytoma. The typical findings are hypertension with tachycardia and flushing. The treatment of choice is laparoscopic (closed) surgery.