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Confirmatory Testing for Primary Aldosteronism

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Primary Aldosteronism

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Abstract

To minimize the influence of medication, potassium, angiotensin 2, and corticotropin, because mechanisms of aldosterone escape have been described, and to increase specificity in the diagnostic process, confirmatory testing is necessary in cases suspected to have primary aldosteronism.

There are different approaches to demonstrate that aldosterone is secreted autonomously, including the proof of insufficient suppression of aldosterone secretion or demonstration of a strong suppression of renin.

Nevertheless, all confirmatory tests have pros and cons and sensitivities or specificities are less than 100 %. Therefore, the confirmation of primary aldosteronism is based on a positive screening test and a positive confirmation test but also on details from the case history and or the patient examination. In addition, a typical postinterventional course with reversal of symptoms and signs characteristic of primary aldosteronism help to document the diagnosis.

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Author information

Authors and Affiliations

  1. Department of Endocrinology and Diabetes, Heinrich-Heine University, Duesseldorf, Germany

    Matthias Haase

  2. Department of Medicine III, Technical University, Dresden, Germany

    Matthias Haase & Matthias Gruber

  3. Department of Nephrology, Heinrich-Heine University, Duesseldorf, Germany

    Xing Gao

  4. Department of Nephrology, German Clinic of Diagnosticsy, Wiesbaden, Germany

    Oliver Vonend

  5. Division of Endocrinology and Metabolism, University of Rostock, Rostock, Germany

    Holger S. Willenberg M.D., Ph.D.

  6. Department of Endocrinology and Diabetes, University Hospital Duesseldorf, Moorenstraße 5, Düsseldorf, 40225, Germany

    Holger S. Willenberg M.D., Ph.D.

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  1. Matthias Haase
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  2. Matthias Gruber
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  3. Xing Gao
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  4. Oliver Vonend
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  5. Holger S. Willenberg M.D., Ph.D.
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Correspondence to Holger S. Willenberg M.D., Ph.D. .

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Editors and Affiliations

  1. Department of Surgery, University Hospital, Uppsala, Sweden

    Per Hellman

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Haase, M., Gruber, M., Gao, X., Vonend, O., Willenberg, H.S. (2014). Confirmatory Testing for Primary Aldosteronism. In: Hellman, P. (eds) Primary Aldosteronism. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-0509-6_10

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