Abstract
A serum potassium determination is usually recommended for new hypertensive patients as a screening test for primary aldosteronism and as a baseline for drug therapy. Since hypokalemia is not specific for aldosteronism, the authors assessed its use and limitations as a screening test in nine reported studies of 303 patients with aldosterone-producing adenomas (n=252) or adrenal hyperplasia (n=51). The optimal potassium cutoff level and the predictive ability of hypokalemia to detect aldosteronism were analyzed in a primary care setting with different diseases, test characteristics, and prevalences. Optimal screening for primary aldosteronism occurred at serum potassium <3.2 mEq/l in a primary care, low-prevalence population, and at higher potassium levels in higher-prevalence populations. Other screening tests, such as urinary aldoster-one levels and plasma renin activity, showed lower individual test performance characteristics, but when combined were similar in performance to serum potassium measurement.
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Received from the General Internal Medicine Division, Department of Medicine, Wright State University School of Medicine, Miami Valley Hospital, and Veteran’s Administration Medical Center, Dayton, Ohio. Dr. Snyder is presently a fellow in the Endocrinology Division, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina.
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Goldenberg, K., Snyder, D.K. Screening for primary aldosteronism. J Gen Intern Med 1, 368–372 (1986). https://doi.org/10.1007/BF02596419
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DOI: https://doi.org/10.1007/BF02596419