Clinical chemistry and laboratory medicine: Oral salt loading combined with postural stimulation tests for confirming and subtyping primary aldosteronism

Cheng, Jenny Yeuk Ki; Lo, Wai Shan Clara; Tsui, Teresa Kam Chi; Chow, Wing Kar Edith; Cheung, Kitty Kit Ting; Ma, Ronald Ching Wan; Ozaki, Risa; Ho, Chung Shun

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Title:: Clinical chemistry and laboratory medicine

Publication:: Berlin [u.a.]: De Gruyter

Note:: Gesehen am 22.6.2022; Archivierung/Langzeitarchivierung gewährleistet; 82+C!EBSCO-Split(17-11-09)

Scope:: Online-Ressource

ISSN:: 1437-4331

ZDB-ID:: 1492732-9

VÖBB-Katalog:: 15133150

Previous Title:: European journal of clinical chemistry and clinical biochemistry

Keywords:: Zeitschrift

Classification:: Naturwissenschaften; Medizin

DDC Group:: 610 Medizin; 540 Chemie

Collection:: Naturwissenschaften; Medizin

Copyright:: Rights reserved

Accessibility:: Eingeschränkter Zugang mit Nutzungsbeschränkungen

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Author:: Cheng, Jenny Yeuk Ki; Lo, Wai Shan Clara; Tsui, Teresa Kam Chi; Chow, Wing Kar Edith; Cheung, Kitty Kit Ting; Ma, Ronald Ching Wan; Ozaki, Risa; Ho, Chung Shun

Title:: Oral salt loading combined with postural stimulation tests for confirming and subtyping primary aldosteronism

Publication:: Berlin [u.a.]: De Gruyter, 2025

Language:: English

Information:: Objectives: Primary aldosteronism (PA) is an underdiagnosed yet important condition. This study aimed to evaluate the diagnostic performance of a combined protocol using oral salt loading and postural stimulation tests (PST), named the balance study, to confirm and subtype PA. Methods: We retrospectively analyzed the data of 402 patients with either confirmed PA or essential hypertension who underwent the balance study. Biochemical markers were measured using liquid chromatography-tandem mass spectrometry. Receiver operating characteristic curves were used to assess the diagnostic performance. The cut-off values for biochemical markers were determined by Youden J’s statistics. Results: For PA confirmation, urinary aldosterone (UALD; area under the curve [AUC] 0.894), urinary tetrahydroaldosterone (UTHA; AUC 0.875), the sum of UALD and UTHA (SUM; AUC 0.884), and supine plasma aldosterone (PALD; AUC 0.902) showed comparable performance. Corresponding cut-offs were: UALD>38 nmol/day, UTHA>160 nmol/day, SUM>259 nmol/day, and supine PALD>273 pmol/L. For PA subtyping, the difference or ratio between erect and supine PALD in PST achieved an AUC of 0.90. An increase of less than 19 pmol/L or less than 5 % from a supine to an erect position suggested an aldosterone-producing adenoma. Conclusions: This combined protocol using oral salt loading and PST could help confirm a diagnosis of PA and predict the subtype. UTHA and supine PALD may add value to UALD for PA confirmation, whereas the erect/supine PALD ratio from PST could assist in PA subtyping. Further studies are required to validate these findings.

Scope:: Online-Ressource

Note:: Open Access; Archivierung/Langzeitarchivierung gewährleistet

Keywords:: primary aldosteronism ; confirmation ; subtyping ; balance study ; postural stimulation test ; urine aldosterone

Classification:: Naturwissenschaften; Medizin

URN:: urn:nbn:de:101:1-2511010615391.006327512252

Collection:: Naturwissenschaften; Medizin

Copyright:: CC BY

Accessibility:: Free Access

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