Abstract.Pseudohypoaldosteronism (PHA) type 1 is a disease showing mineralocorticoid resistance in
the kidney and/or other mineralocorticoid target tissues. Patients with PHA1 present very
high plasma aldosterone and renin levels, but they develop excessive salt wasting. There
are three types of PHA1. The systemic form of PHA1 is inherited in an autosomal recessive
manner and causes severe life-long salt loss in multiple target tissues, such as sweat
glands, salivary glands, the colonic epithelium, and the lung. In the systemic form of
PHA1, life-long salt supplementation is necessary. The second type is the renal form,
where aldosterone resistance is shown only in the kidney, and its inheritance is autosomal
dominant. In the renal form of PHA1, salt supplementation generally becomes unnecessary by
1–3 yr of age. The third type is the secondary PHA1, which is strongly associated with
urinary tract infections and/or urinary tract malformations. This review summarizes the
clinical features and molecular basis of PHA1. Understanding of its pathogenesis can be
helpful for the early diagnosis and clinical care of affected children with PHA1.