Comparison of confirmatory tests for the diagnosis of primary aldosteronism

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dc.contributor.authorMulatero, Paolo
dc.contributor.authorMilan, Alberto
dc.contributor.authorFallo, Francesco
dc.contributor.authorRegolisti, Giuseppe
dc.contributor.authorPizzolo, Francesca
dc.contributor.authorFardella, Carlos
dc.contributor.authorMosso, Lorena
dc.contributor.authorMarafetti, Lisa
dc.contributor.authorVeglio, Franco
dc.contributor.authorMaccario, Mauro
dc.date.accessioned2024-01-10T12:04:42Z
dc.date.available2024-01-10T12:04:42Z
dc.date.issued2006
dc.description.abstractContext: Primary aldosteronism (PA) is the most frequent form of secondary hypertension, accounting for up to 5-10% of all hypertensive patients, and the diagnosis of PA can present an important challenge for the clinician. After a positive screening test, the diagnosis is confirmed by a suppression test, often an iv saline load test (SLT) or a fludrocortisone suppression test (FST). The FST is considered by many to be the most reliable but is more complex and expensive.
dc.description.abstractObjective and Design: Our objective was to compare the specificity of SLT with FST for the diagnosis of PA.
dc.description.abstractPatients and Setting: The study included 100 hypertensive patients referred to hypertension units with suspected PA after the screening test.
dc.description.abstractIntervention: All patients underwent FST and SLT.
dc.description.abstractMain Outcome Measures: We assessed plasma aldosterone concentrations (PAC) before and after FST and SLT.
dc.description.abstractResults: After iv SLT, 10.4% of the PA patients were negative and 16.1% of patients with essential hypertension were positive after SLT; that is, a correct diagnosis with SLT was obtained in 88% of patients compared with FST. PAC after SLT and PAC after FST were highly correlated (P < 0.0001). Receiver operator characteristic curve analysis demonstrated that the best cutoff for PAC after SLT was 5 ng/dl. Patients with aldosterone-producing adenoma displayed a smaller reduction of PAC compared with patients with bilateral adrenal hyperplasia; a PAC after SLT greater than 6 ng/dl identified all patients eventually diagnosed as having aldosterone-producing adenoma.
dc.description.abstractConclusions: This study demonstrates that the iv SLT is a reasonably good alternative to the more expensive and complex FST for the diagnosis of PA after a positive screening test.
dc.fechaingreso.objetodigital2024-05-15
dc.format.extent6 páginas
dc.fuente.origenWOS
dc.identifier.doi10.1210/jc.2006-0078
dc.identifier.eissn1945-7197
dc.identifier.issn0021-972X
dc.identifier.pubmedidMEDLINE:16670162
dc.identifier.urihttps://doi.org/10.1210/jc.2006-0078
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/75863
dc.identifier.wosidWOS:000238840600027
dc.information.autorucMedicina;Fardella C;S/I;66235
dc.information.autorucMedicina;Mosso L;S/I;88201
dc.issue.numero7
dc.language.isoen
dc.nota.accesocontenido parcial
dc.pagina.final2623
dc.pagina.inicio2618
dc.publisherENDOCRINE SOC
dc.revistaJOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
dc.rightsacceso restringido
dc.subjectRENIN RATIO
dc.subjectPRIMARY HYPERALDOSTERONISM
dc.subjectPLASMA-ALDOSTERONE
dc.subjectPREVALENCE
dc.subjectINFUSION
dc.subjectADENOMA
dc.subjectFORMS
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleComparison of confirmatory tests for the diagnosis of primary aldosteronism
dc.typeartículo
dc.volumen91
sipa.codpersvinculados66235
sipa.codpersvinculados88201
sipa.indexWOS
sipa.indexScopus
sipa.trazabilidadCarga SIPA;09-01-2024
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