The adrenal glands are located on top of the kidneys. The adrenal glands consist of the medullar the inner section and the cortex which surrounds it. The cortex contains 3 layers; the zona glomerulosa on the outside, zona fasciculata and the inner most layer the zona reticularis. These produce various hormones that are involved in the regulation of blood sugar, sex hormones and blood volume.
Primary adrenal insufficiency, also known as Addison’s disease is a condition that affected the adrenal glands so they do not produce enough steroid hormone. The cause of this is usually an autoimmune destruction of the adrenal glands. This destruction might not be clinically apparent for a number of years as the adrenal glands have an amazing ability to compensate in production of hormones.
Addison’s disease is more commonly picked up when the patient is put through a major stressor such as surgery and the body is unable to produce glucocorticoids as a response, this is known as an Addisonian crisis. This results in a hypotension (a drop-in blood pressure) that can result in clinical shock. Due to the adrenal glands control of electrolytes within the kidneys an Addisonian crisis results in a drop in pH within the blood leading to a metabolic acidosis. This crisis can be fatal so as soon as it is suspected treatment of hydrocortisone should be commenced in high doses.