Abstract | INTRODUCTION: Assessment of the renin-angiotensin-aldosterone system has been recently granted a much greater role in the evaluation of patients with arterial hypertension. There is no single test efficient in selection of patients for second-step etiological investigation. METHODS: Altogether, 198 consecutive patients--119 women (60%) and 79 men (40%)--hospitalized in years 2009-2011 at the Clinical Department of Endocrinology Medical University of Bialystok were diagnosed with primary aldosteronism. In each patient, plasma renin activity and plasma aldosterone concentration (basic and after 2 l NaCl infusion) were evaluated. RESULTS: The percentage of patients with plasma aldosterone concentration ≥ 15 ng/ml was 53 and the percentage of patients with plasma renin activity ≤ 0.1 ng/ml/h was 20. The percentage of patients screened for primary aldosteronism in which the aldosterone: renin ratio exceeded consecutive cut-offs of 20, 30, 40 and 50 were respectively 57, 45, 34 and 29. Among 15 patients in which plasma aldosterone concentration after infusion of 2 l of saline was ≥ 6.5 ng/dl (8.6%), 13 (6.6%) were diagnosed with primary aldosteronism. CONCLUSION: The obligatory use of tests confirming autonomy of aldosterone secretion in patients screened for primary aldosteronism seems cost-effective in limiting the number of patients for further diagnosis.
|
Authors | Janusz Myśliwiec, Łukasz Zukowski, Anna Grodzka, Agata Piłaszewicz, Szymon Dragowski, Maria Górska |
Journal | Journal of the renin-angiotensin-aldosterone system : JRAAS
(J Renin Angiotensin Aldosterone Syst)
Vol. 13
Issue 3
Pg. 367-71
(Sep 2012)
ISSN: 1752-8976 [Electronic] England |
PMID | 22406967
(Publication Type: Journal Article)
|
Chemical References |
- Sodium Chloride
- Aldosterone
- Renin
|
Topics |
- Aldosterone
(blood)
- Diagnostic Tests, Routine
(methods)
- Female
- Humans
- Hyperaldosteronism
(blood, diagnosis)
- Male
- Middle Aged
- ROC Curve
- Renin
(blood)
- Reproducibility of Results
- Sodium Chloride
(administration & dosage)
|