What is a significant complication of untreated primary adrenal insufficiency?

In the context of untreated primary adrenal insufficiency, a significant complication is hypotension. Primary adrenal insufficiency, also known as Addison's disease, leads to inadequate production of adrenal hormones, particularly cortisol and aldosterone. Cortisol is crucial for maintaining vascular tone and modulating blood pressure by helping with the regulation of sodium retention and water balance. When cortisol levels are low due to adrenal insufficiency, patients may experience a drop in blood pressure, leading to symptoms such as dizziness, fainting, and in severe cases, adrenal crisis, which can be life-threatening.

The lack of aldosterone impacts the kidney's ability to retain sodium, which further exacerbates hypotension due to the loss of sodium and fluid. As a result, untreated patients may face significant complications related to chronic low blood pressure, including fatigue, weakness, and dehydration.

While hyperglycemia, fluid overload, and hypercalcemia are notable concerns in various clinical contexts, they are not directly related to primary adrenal insufficiency in the same way that hypotension is. Therefore, hypotension stands out as a primary and critical complication in this scenario.