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Suppression of Aldosterone Secretion After Recumbent Saline Infusion Does Not Exclude Lateralized Primary Aldosteronism
- Source :
- Hypertension. 68:989-994
- Publication Year :
- 2016
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2016.
-
Abstract
- Guidelines recommend suppression tests such as the saline infusion test (SIT) to ascertain the diagnosis of primary aldosteronism (PA) in patients with a high aldosterone:renin ratio. However, suppression tests have only been evaluated in small retrospective series, and some experts consider that they are not helpful for the diagnosis of PA. In this study, we evaluated whether low post-SIT aldosterone concentrations do exclude lateralized PA. Between February 2009 and December 2013, 199 patients diagnosed with PA on the basis of 2 elevated aldosterone:renin ratio results and a high basal plasma or urinary aldosterone level or high post-SIT aldosterone level had a selective adrenal venous sampling. We used a selectivity index of 2 and a lateralization index of 4 to interpret the adrenal venous sampling results. Baseline characteristics of the patients were the following (percent or median): men 63%, 48 years old, office blood pressure 142/88 mm Hg, serum potassium 3.4 mmol/L, aldosterone:renin ratio 113 pmol/mU, plasma aldosterone concentration 588 pmol/L. The proportion of patients with lateralized adrenal venous sampling was 12 of 41 (29%) among those with post-SIT aldosterone
- Subjects :
- Adult
Male
medicine.medical_specialty
medicine.medical_treatment
030209 endocrinology & metabolism
Sodium Chloride
030204 cardiovascular system & hematology
Cohort Studies
Diagnostic Techniques, Endocrine
03 medical and health sciences
Basal (phylogenetics)
chemistry.chemical_compound
0302 clinical medicine
Primary aldosteronism
Internal medicine
Hyperaldosteronism
Preoperative Care
Renin
Renin–angiotensin system
Internal Medicine
medicine
Humans
Infusions, Intravenous
Aldosterone
Saline
Retrospective Studies
business.industry
Patient Selection
Adrenalectomy
Middle Aged
Prognosis
medicine.disease
Treatment Outcome
Endocrinology
Blood pressure
chemistry
Female
France
business
Subjects
Details
- ISSN :
- 15244563 and 0194911X
- Volume :
- 68
- Database :
- OpenAIRE
- Journal :
- Hypertension
- Accession number :
- edsair.doi.dedup.....45e5ecd03a700ed796e586320b439ab0