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Reassessment of Urinary Aldosterone Measurement After Saline Infusion in Primary Aldosteronism

CONTEXT: Urinary aldosterone levels (Uald) are widely measured in the oral sodium-loading test to confirm primary aldosteronism (PA), but reliable studies on their diagnostic value are limited. This may be due to the difficulty in collecting urine with reliable accuracy, keeping oral sodium intake c...

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Autores principales: Kaneko, Hiroki, Umakoshi, Hironobu, Ishihara, Yuki, Nanba, Kazutaka, Tsuiki, Mika, Kusakabe, Toru, Satoh-Asahara, Noriko, Yasoda, Akihiro, Tagami, Tetsuya
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7417007/
https://www.ncbi.nlm.nih.gov/pubmed/32803096
http://dx.doi.org/10.1210/jendso/bvaa100
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author Kaneko, Hiroki
Umakoshi, Hironobu
Ishihara, Yuki
Nanba, Kazutaka
Tsuiki, Mika
Kusakabe, Toru
Satoh-Asahara, Noriko
Yasoda, Akihiro
Tagami, Tetsuya
author_facet Kaneko, Hiroki
Umakoshi, Hironobu
Ishihara, Yuki
Nanba, Kazutaka
Tsuiki, Mika
Kusakabe, Toru
Satoh-Asahara, Noriko
Yasoda, Akihiro
Tagami, Tetsuya
author_sort Kaneko, Hiroki
collection PubMed
description CONTEXT: Urinary aldosterone levels (Uald) are widely measured in the oral sodium-loading test to confirm primary aldosteronism (PA), but reliable studies on their diagnostic value are limited. This may be due to the difficulty in collecting urine with reliable accuracy, keeping oral sodium intake constant between patients. Therefore, we focused on 24-hour Uald after intravenous saline infusion in a hospitalized setting, which provides a reliable sodium load in consistent amounts. OBJECTIVE: Comparing plasma aldosterone concentrations (PAC) and Uald after saline infusion in the sitting position, to evaluate the accuracy in determining PA subtypes and the correlation of both measurements. DESIGN AND SETTING: This was a retrospective cross-sectional study in a single referral center. PATIENTS: Of 53 patients without renal dysfunction who were diagnosed with PA and underwent adrenal venous sampling, 16 and 37 were diagnosed with unilateral and bilateral PA, respectively. MAIN OUTCOME MEASURES: Uald collected for 24 hours and PAC after saline infusion. RESULTS: The area under the receiver operating characteristic curve for diagnosing unilateral PA was not significantly different between Uald and PAC after saline infusion (0.921 and 0.958, respectively; P = 0.370). The predicted optimal cutoff value of Uald was 16.5 μg/day (sensitivity, 87.5%; specificity, 100%), and that of PAC after saline infusion was 19.3 ng/dL (sensitivity, 87.5%; specificity, 97.3%). In studied patients with PA, Uald was positively correlated with PAC after saline infusion (r = 0.617; P < 0.001). CONCLUSIONS: We reassessed Uald in PA patients under sufficient sodium loading and demonstrated the correlation between Uald and PAC after saline infusion.
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spelling pubmed-74170072020-08-13 Reassessment of Urinary Aldosterone Measurement After Saline Infusion in Primary Aldosteronism Kaneko, Hiroki Umakoshi, Hironobu Ishihara, Yuki Nanba, Kazutaka Tsuiki, Mika Kusakabe, Toru Satoh-Asahara, Noriko Yasoda, Akihiro Tagami, Tetsuya J Endocr Soc Clinical Research Articles CONTEXT: Urinary aldosterone levels (Uald) are widely measured in the oral sodium-loading test to confirm primary aldosteronism (PA), but reliable studies on their diagnostic value are limited. This may be due to the difficulty in collecting urine with reliable accuracy, keeping oral sodium intake constant between patients. Therefore, we focused on 24-hour Uald after intravenous saline infusion in a hospitalized setting, which provides a reliable sodium load in consistent amounts. OBJECTIVE: Comparing plasma aldosterone concentrations (PAC) and Uald after saline infusion in the sitting position, to evaluate the accuracy in determining PA subtypes and the correlation of both measurements. DESIGN AND SETTING: This was a retrospective cross-sectional study in a single referral center. PATIENTS: Of 53 patients without renal dysfunction who were diagnosed with PA and underwent adrenal venous sampling, 16 and 37 were diagnosed with unilateral and bilateral PA, respectively. MAIN OUTCOME MEASURES: Uald collected for 24 hours and PAC after saline infusion. RESULTS: The area under the receiver operating characteristic curve for diagnosing unilateral PA was not significantly different between Uald and PAC after saline infusion (0.921 and 0.958, respectively; P = 0.370). The predicted optimal cutoff value of Uald was 16.5 μg/day (sensitivity, 87.5%; specificity, 100%), and that of PAC after saline infusion was 19.3 ng/dL (sensitivity, 87.5%; specificity, 97.3%). In studied patients with PA, Uald was positively correlated with PAC after saline infusion (r = 0.617; P < 0.001). CONCLUSIONS: We reassessed Uald in PA patients under sufficient sodium loading and demonstrated the correlation between Uald and PAC after saline infusion. Oxford University Press 2020-07-22 /pmc/articles/PMC7417007/ /pubmed/32803096 http://dx.doi.org/10.1210/jendso/bvaa100 Text en © Endocrine Society 2020. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Clinical Research Articles
Kaneko, Hiroki
Umakoshi, Hironobu
Ishihara, Yuki
Nanba, Kazutaka
Tsuiki, Mika
Kusakabe, Toru
Satoh-Asahara, Noriko
Yasoda, Akihiro
Tagami, Tetsuya
Reassessment of Urinary Aldosterone Measurement After Saline Infusion in Primary Aldosteronism
title Reassessment of Urinary Aldosterone Measurement After Saline Infusion in Primary Aldosteronism
title_full Reassessment of Urinary Aldosterone Measurement After Saline Infusion in Primary Aldosteronism
title_fullStr Reassessment of Urinary Aldosterone Measurement After Saline Infusion in Primary Aldosteronism
title_full_unstemmed Reassessment of Urinary Aldosterone Measurement After Saline Infusion in Primary Aldosteronism
title_short Reassessment of Urinary Aldosterone Measurement After Saline Infusion in Primary Aldosteronism
title_sort reassessment of urinary aldosterone measurement after saline infusion in primary aldosteronism
topic Clinical Research Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7417007/
https://www.ncbi.nlm.nih.gov/pubmed/32803096
http://dx.doi.org/10.1210/jendso/bvaa100
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