Skip to main content

Advertisement

SpringerLink
Log in

Is adrenal venous sampling always necessary to differentiate between unilateral and bilateral primary aldosteronism? Lesson from the SPAIN-ALDO register

  • Original Article
  • Published:
Endocrine Aims and scope Submit manuscript

Abstract

Purpose

To evaluate whether the clinical, biochemical and radiological features of patients with primary aldosteronism (PA) can predict both main subtypes of PA.

Methods

A retrospective multicenter study of PA patients followed in 27 Spanish tertiary hospitals (SPAIN-ALDO Register). Only patients with confirmed unilateral or bilateral PA based on adrenal venous sampling (AVS) and/or postsurgical biochemical cure after adrenalectomy were included. Supervised regression techniques were used for model development.

Results

328 patients [270 unilateral PA (UPA), 58 bilateral PA (BPA)] were included. The area under the curve (AUC) for aldosterone/potassium ratio and aldosterone responses following saline infusion test were 0.602 [95%CI 0.520 to 0.684] and 0.574 [95% CI 0.446–0.701], respectively, to differentiate UPA from BPA. The AUC was 0.825 [95% 0.764–0.886] when the prediction model with seven parameters – comorbidities (dyslipidemia, cerebrovascular disease, sleep apnea syndrome [SAS]), systolic blood pressure (SBP), plasma aldosterone levels (PAC), hypokalemia and unilateral adrenal nodule >1 cm and normal contralateral adrenal gland on CT/MRI – was used. In patients without comorbidities, hypokalemia, SBP > 160 mmHg, PAC > 40 ng/dL, and unilateral adrenal lesions were associated with a likelihood of having a UPA of 98.5%. The chance of BPA was higher in individuals with comorbidities, SBP < 140 mmHg, normokalemia, low PAC levels, and no adrenal tumors on the CT/MRI (91.5%).

Conclusion

A combination of high PAC, SBP > 160 mmHg, low serum potassium, a unilateral adrenal nodule>1 cm and no comorbidities could predict a UPA with a 98.5% accuracy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. J.W. Funder, R.M. Carey, C. Fardella, C.E. Gomez-Sanchez, F. Mantero, M. Stowasser, W.F. Young Jr, V.M. Montori, Case detection, diagnosis, and treatment of patients with primary aldosteronism: an endocrine society clinical practice guideline. J. Clin. Endocrinol. Metab. 93(9 Sep), 3266–81 (2008). https://doi.org/10.1210/jc.2008-0104.

    Article  CAS  PubMed  Google Scholar 

  2. P. Mulatero, S. Monticone, J. Deinum, L. Amar, A. Prejbisz, M.C. Zennaro, F. Beuschlein, G.P. Rossi, T. Nishikawa, A. Morganti, T.M. Seccia, Y.H. Lin, F. Fallo, J. Widimsky, Genetics, prevalence, screening and confirmation of primary aldosteronism: a position statement and consensus of the Working Group on Endocrine Hypertension of The European Society of Hypertension. J. Hypertens. 38(10 Oct), 1919–1928 (2020). https://doi.org/10.1097/HJH.0000000000002510.

    Article  CAS  PubMed  Google Scholar 

  3. T. Nishikawa, M. Omura, F. Satoh, H. Shibata, K. Takahashi, N. Tamura, A. Tanabe; Task Force Committee on Primary Aldosteronism, The Japan Endocrine Society, Guidelines for the diagnosis and treatment of primary aldosteronism–the Japan Endocrine Society 2009. Endocr. J. 58(9), 711–21 (2011). https://doi.org/10.1507/endocrj.ej11-0133.

    Article  CAS  PubMed  Google Scholar 

  4. L. Amar, J.P. Baguet, S. Bardet, P. Chaffanjon, B. Chamontin, C. Douillard, P. Durieux, X. Girerd, P. Gosse, A. Hernigou, D. Herpin, P. Houillier, X. Jeunemaitre, F. Joffre, J.L. Kraimps, H. Lefebvre, F. Ménégaux, C. Mounier-Véhier, J. Nussberger, J.Y. Pagny, A. Pechère, P.F. Plouin, Y. Reznik, O. Steichen, A. Tabarin, M.C. Zennaro, F. Zinzindohoue, O. Chabre, SFE/SFHTA/AFCE primary aldosteronism consensus: Introduction and handbook. Ann. Endocrinol. (Paris) 77(3 Jul), 179–86 (2016). https://doi.org/10.1016/j.ando.2016.05.001.

    Article  PubMed  Google Scholar 

  5. G.P. Rossi, R.J. Auchus, M. Brown, J.W. Lenders, M. Naruse, P.F. Plouin, F. Satoh, W.F. Young Jr, An expert consensus statement on use of adrenal vein sampling for the subtyping of primary aldosteronism. Hypertension 63(1 Jan), 151–60 (2014). https://doi.org/10.1161/HYPERTENSIONAHA.113.02097.

    Article  CAS  Google Scholar 

  6. W.F. Young, A.W. Stanson, G.B. Thompson, C.S. Grant, D.R. Farley, J.A. van Heerden, Role for adrenal venous sampling in primary aldosteronism. Surgery 136(6 Dec), 1227–35 (2004). https://doi.org/10.1016/j.surg.2004.06.051.

    Article  PubMed  Google Scholar 

  7. F. Lumachi, M. Ermani, S.M. Basso, D. Armanini, M. Iacobone, G. Favia, Long-term results of adrenalectomy in patients with aldosterone-producing adenomas: multivariate analysis of factors affecting unresolved hypertension and review of the literature. Am. Surg. 71(10 Oct), 864–9 (2005).

    Article  PubMed  Google Scholar 

  8. E.M. Küpers, L. Amar, A. Raynaud, P.F. Plouin, O. Steichen, A clinical prediction score to diagnose unilateral primary aldosteronism. J. Clin. Endocrinol. Metab. 97(10 Oct), 3530–7 (2012). https://doi.org/10.1210/jc.2012-1917.

    Article  CAS  PubMed  Google Scholar 

  9. J. Burrello, A. Burrello, J. Pieroni, E. Sconfienza, V. Forestiero, P. Rabbia, C. Adolf, M. Reincke, F. Veglio, T.A. Williams, S. Monticone, P. Mulatero, Development and validation of prediction models for subtype diagnosis of patients with primary aldosteronism. J. Clin. Endocrinol. Metab. 105(10 Oct), dgaa379 (2020). https://doi.org/10.1210/clinem/dgaa379.

    Article  PubMed  Google Scholar 

  10. H. Kobayashi, M. Abe, M. Soma, Y. Takeda, I. Kurihara, H. Itoh, H. Umakoshi, M. Tsuiki, T. Katabami, T. Ichijo, N. Wada, T. Yoshimoto, Y. Ogawa, J. Kawashima, M. Sone, N. Inagaki, K. Takahashi, M. Watanabe, Y. Matsuda, H. Shibata, K. Kamemura, T. Yanase, M. Otsuki, Y. Fujii, K. Yamamoto, A. Ogo, K. Nanba, A. Tanabe, T. Suzuki, M. Naruse, Development and validation of subtype prediction scores for the workup of primary aldosteronism. J. Hypertens. 36(11 Nov), 2269–2276 (2018). https://doi.org/10.1097/HJH.0000000000001855.

    Article  CAS  PubMed  Google Scholar 

  11. K. Nanba, M. Tsuiki, K. Nakao, A. Nanba, T. Usui, T. Tagami, Y. Hirokawa, H. Okuno, T. Suzuki, T. Shimbo, A. Shimatsu, M. Naruse, A subtype prediction score for primary aldosteronism. J. Hum. Hypertens. 28(12 Dec), 716–20 (2014). https://doi.org/10.1038/jhh.2014.20.

    Article  CAS  PubMed  Google Scholar 

  12. N. Wada, A. Miyoshi, H. Usubuchi, S. Terae, Y. Shibayama, B. Takahashi, S. Baba, H. Sugawara, S. Obara, Prediction of unilateral hyperaldosteronism on adrenal vein sampling using captopril challenge test in patients with primary aldosteronism. Endocr. J. 68(1 Jan), 45–51 (2021). https://doi.org/10.1507/endocrj.EJ20-0329.

    Article  CAS  PubMed  Google Scholar 

  13. H. Nagano, T. Kono, A. Saiga, Y. Kubota, M. Fujimoto, S.J.A. Felizola, K. Ishiwata, A. Tamura, S. Higuchi, I. Sakuma, N. Hashimoto, S. Suzuki, H. Koide, N. Takeshita, S. Sakamoto, T. Ban, K. Yokote, Y. Nakamura, T. Ichikawa, T. Uno, T. Tanaka, Aldosterone reduction rate after saline infusion test may be a novel prediction in patients with primary aldosteronism. J. Clin. Endocrinol. Metab. 105(3 Mar), dgz092 (2020). https://doi.org/10.1210/clinem/dgz092.

    Article  PubMed  Google Scholar 

  14. T. Kocjan, G. Vidmar, P. Popović, M. Stanković, Validation of three novel clinical prediction tools for primary aldosteronism subtyping. Endocr. Connect 11(5 May), e210532 (2022). https://doi.org/10.1530/EC-21-0532.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. H. Umakoshi, M. Tsuiki, Y. Takeda, I. Kurihara, H. Itoh, T. Katabami, T. Ichijo, N. Wada, T. Yoshimoto, Y. Ogawa, J. Kawashima, M. Sone, N. Inagaki, K. Takahashi, M. Watanabe, Y. Matsuda, H. Kobayashi, H. Shibata, K. Kamemura, M. Otsuki, Y. Fujii, K. Yamamto, A. Ogo, T. Yanase, T. Suzuki, M. Naruse; JPAS Study Group, Significance of computed tomography and serum potassium in predicting subtype diagnosis of primary aldosteronism. J. Clin. Endocrinol. Metab. 103(3 Mar), 900–908 (2018). https://doi.org/10.1210/jc.2017-01774.

    Article  PubMed  Google Scholar 

  16. T.H. Puar, W.J. Loh, D.S. Lim, L.M. Loh, M. Zhang, R.S. Foo, L. Lee, D.S. Swee, J. Khoo, D. Tay, J.W. Kam, T. Dekkers, M. Velema, J. Deinum, P.C. Kek, Aldosterone-potassium ratio predicts primary aldosteronism subtype. J. Hypertens. 38(7 Jul), 1375–1383 (2020). https://doi.org/10.1097/HJH.0000000000002348.

    Article  CAS  PubMed  Google Scholar 

  17. M. Araujo-Castro, M. Paja Fano, M. González Boillos, B. Pla Peris, E. Pascual-Corrales, A.M. García Cano, P. Parra Ramírez, P.M. Rojas-Marcos, J.G. Ruiz-Sanchez, A. Vicente Delgado, E. Gómez Hoyos, R. Ferreira, I. García Sanz, M. Recasens Sala, R. Barahona San Millan, M.J. Picón César, P. Díaz Guardiola, J.J. García González, C.M. Perdomo, L. Manjón Miguélez, R. García Centeno, J.C. Percovich, Á. Rebollo Román, P. Gracia Gimeno, C. Robles Lázaro, M. Morales-Ruiz, F.A. Hanzu, Adrenal venous sampling in primary aldosteronism: experience of a Spanish multicentric study (Results from the SPAIN-ALDO Register). Endocrine 78(2 Nov), 363–372 (2022). https://doi.org/10.1007/s12020-022-03122-8.

    Article  CAS  PubMed  Google Scholar 

  18. M. Araujo-Castro, M. Paja Fano, M. González Boillos, B. Pla Peris, E. Pascual-Corrales, A.M. García Cano, P. Parra Ramírez, P.M. Rojas-Marcos, J.G. Ruiz-Sanchez, A. Vicente Delgado, E. Gómez Hoyos, R. Ferreira, I. García Sanz, P. Díaz Guardiola, J.J. García González, C.M. Perdomo, M. Morales, F.A. Hanzu, Evolution of the cardiometabolic profile of primary hyperaldosteronism patients treated with adrenalectomy and with mineralocorticoid receptor antagonists: results from the SPAIN-ALDO registry. Endocrine 76(3 Jun), 687–696 (2022). https://doi.org/10.1007/s12020-022-03029-4.

    Article  CAS  PubMed  Google Scholar 

  19. P.A. Harris, R. Taylor, B.L. Minor, V. Elliott, M. Fernandez, L. O’Neal, L. McLeod, G. Delacqua, F. Delacqua, J. Kirby, S.N. Duda, The REDCap consortium: Building an international community of software platform partners. J. Biomed. Inf. 95(Jul), 103208 (2019). https://doi.org/10.1016/j.jbi.2019.103208.

    Article  Google Scholar 

  20. P.A. Harris, R. Taylor, R. Thielke, J. Payne, N. Gonzalez, J.G. Conde, Research electronic data capture (REDCap)–a metadata-driven methodology and workflow process for providing translational research informatics support. J. Biomed. Inf. 42(2 Apr), 377–81 (2009). https://doi.org/10.1016/j.jbi.2008.08.010.

    Article  Google Scholar 

  21. T.A. Williams, J.W.M. Lenders, P. Mulatero, J. Burrello, M. Rottenkolber, C. Adolf, F. Satoh, L. Amar, M. Quinkler, J. Deinum, F. Beuschlein, K.K. Kitamoto, U. Pham, R. Morimoto, H. Umakoshi, A. Prejbisz, T. Kocjan, M. Naruse, M. Stowasser, T. Nishikawa, W.F. Young Jr, C.E. Gomez-Sanchez, J.W. Funder, M. Reincke; Primary Aldosteronism Surgery Outcome (PASO) investigators, Outcomes after adrenalectomy for unilateral primary aldosteronism: an international consensus on outcome measures and analysis of remission rates in an international cohort. Lancet Diabetes Endocrinol. 5(9 Sep), 689–699 (2017). https://doi.org/10.1016/S2213-8587(17)30135-3.

    Article  PubMed  PubMed Central  Google Scholar 

  22. S.H. Kim, J.H. Ahn, H.C. Hong, H.Y. Choi, Y.J. Kim, N.H. Kim, H.J. Yoo, H.Y. Kim, J.A. Seo, N.H. Kim, S.G. Kim, K.M. Choi, S.H. Baik, D.S. Choi, Changes in the clinical manifestations of primary aldosteronism. Korean J. Intern Med 29(2 Mar), 217–25 (2014). https://doi.org/10.3904/kjim.2014.29.2.217.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. D.A. Heinrich, C. Adolf, L.C. Rump, I. Quack, M. Quinkler, S. Hahner, A. Januszewicz, J. Seufert, H.S. Willenberg, N. Nirschl, L. Sturm, F. Beuschlein, M. Reincke, Primary aldosteronism: key characteristics at diagnosis: a trend toward milder forms. Eur. J. Endocrinol. 178(6 Jun), 605–611 (2018). https://doi.org/10.1530/EJE-17-0978.

    Article  CAS  PubMed  Google Scholar 

  24. Z. Zhang, Q. Luo, T. Tuersun, G. Wang, T. Wu, D. Zhang, M. Wang, K. Zhou, L. Sun, N. Yue, N. Li, Higher prevalence of metabolic disorders in patients with bilateral primary aldosteronism than unilateral primary aldosteronism. Clin. Endocrinol. (Oxf.) 94(1 Jan), 3–11 (2021). https://doi.org/10.1111/cen.14318.

    Article  CAS  PubMed  Google Scholar 

  25. R. Holaj, P. Waldauf, D. Wichterle, J. Kvasnička, T. Zelinka, O. Petrák, Z. Krátká, L. Forejtová, J. Kaván, J. Widimský Jr, Adrenal venous sampling could be omitted before surgery in patients with conn’s adenoma confirmed by computed tomography and higher normal aldosterone concentration after saline infusion test. Diagnostics (Basel) 12(7 Jul), 1718 (2022). https://doi.org/10.3390/diagnostics12071718.

    Article  CAS  PubMed  Google Scholar 

  26. Z. Somlóová, J. Widimský Jr, J. Rosa, D. Wichterle, B. Strauch, O. Petrák, T. Zelinka, J. Vlková, M. Masek, J. Dvoráková, R. Holaj, The prevalence of metabolic syndrome and its components in two main types of primary aldosteronism. J. Hum. Hypertens. 24(10 Oct), 625–30 (2010). https://doi.org/10.1038/jhh.2010.65.

    Article  CAS  PubMed  Google Scholar 

  27. F.J. Zuo, X.H. Zhou, Y. Ren, T. Chen, H.M. Tian, [Clinical characteristics of aldosterone producing adenoma and idiopathic hyperaldosteronism with obstructive sleep apnea hypopnea syndrome]. Sichuan Da Xue Xue Bao Yi Xue Ban. 51(3 May), 298–303 (2020). https://doi.org/10.12182/20200560602.

    Article  PubMed  Google Scholar 

  28. F. Buffolo, Q. Li, S. Monticone, D.A. Heinrich, A. Mattei, J. Pieroni, M. Mei, S. Yang, Y.H. Hu, M.C. Yang, C. Sabbadin, F. Pizzolo, G. Giacchetti, F. Fallo, F. Veglio, M. Reincke, V.C. Wu, P. Mulatero, Primary aldosteronism and obstructive sleep apnea: a cross-sectional multi-ethnic study. Hypertension 74(6 Dec), 1532–1540 (2019). https://doi.org/10.1161/HYPERTENSIONAHA.119.13833.

    Article  CAS  Google Scholar 

  29. Y. Song, S. Yang, W. He, J. Hu, Q. Cheng, Y. Wang, T. Luo, L. Ma, Q. Zhen, S. Zhang, M. Mei, Z. Wang, H. Qing, D. Bruemmer, B. Peng, Q. Li; Chongqing Primary Aldosteronism Study (CONPASS) Group†, Confirmatory tests for the diagnosis of primary aldosteronism: a prospective diagnostic accuracy study. Hypertension 71(1 Jan), 118–124 (2018). https://doi.org/10.1161/HYPERTENSIONAHA.117.10197.

    Article  CAS  PubMed  Google Scholar 

  30. S. Wu, J. Yang, J. Hu, Y. Song, W. He, S. Yang, R. Luo, Q. Li, Confirmatory tests for the diagnosis of primary aldosteronism: a systematic review and meta-analysis. Clin. Endocrinol. (Oxf.) 90(5 May), 641–648 (2019). https://doi.org/10.1111/cen.13943.

    Article  PubMed  Google Scholar 

  31. M.J. Kempers, J.W. Lenders, L. van Outheusden, G.J. van der Wilt, L.J. Schultze Kool, A.R. Hermus, J. Deinum, Systematic review: diagnostic procedures to differentiate unilateral from bilateral adrenal abnormality in primary aldosteronism. Ann. Intern Med 151(5 Sep), 329–37 (2009). https://doi.org/10.7326/0003-4819-151-5-200909010-00007.

    Article  PubMed  Google Scholar 

  32. T. Dekkers, A. Prejbisz, L.J.S. Kool, H.J.M.M. Groenewoud, M. Velema, W. Spiering, S. Kołodziejczyk-Kruk, M. Arntz, J. Kądziela, J.F. Langenhuijsen, M.N. Kerstens, A.H. van den Meiracker, B.J. van den Born, F.C.G.J. Sweep, A.R.M.M. Hermus, A. Januszewicz, A.F. Ligthart-Naber, P. Makai, G.J. van der Wilt, J.W.M. Lenders, J. Deinum, Adrenal vein sampling versus CT scan to determine treatment in primary aldosteronism: an outcome-based randomised diagnostic trial. Lancet Diabetes Endocrinol. 4(9 Sep), 739–746 (2016). https://doi.org/10.1016/S2213-8587(16)30100-0.

    Article  PubMed  Google Scholar 

Download references

Funding

This research was funded by Sociedad Española de Endocrinología y Nutrición (SEEN).

Author information

Authors and Affiliations

  1. Endocrinology & Nutrition Department, Hospital Universitario La Paz Madrid, Madrid, Spain

    Paola Parra Ramírez & Patricia Martín Rojas-Marcos

  2. Endocrinology & Nutrition Department. OSI Bilbao-Basurto, Hospital Universitario de Basurto, Bilbao, Spain

    Miguel Paja Fano

  3. Medicine Department, Basque Country University, Bilbao, Spain

    Miguel Paja Fano

  4. Endocrinology & Nutrition Department, Hospital Universitario de Castellón, Castellón, Spain

    Marga González Boillos & Begoña Pla Peris

  5. Instituto de Investigación Biomédica Ramón y Cajal (IRYCIS), Madrid, Spain

    Eider Pascual-Corrales & Marta Araujo-Castro

  6. Endocrinology & Nutrition Department, Hospital Universitario Ramón y Cajal, Madrid, Spain

    Eider Pascual-Corrales & Marta Araujo-Castro

  7. Biochemistry Department, Hospital Universitario Ramón y Cajal, Madrid, Spain

    Ana María García Cano

  8. Endocrinology & Nutrition Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain

    Jorge Gabriel Ruiz-Sanchez & Diego Meneses

  9. Endocrinology & Nutrition Department, Hospital Universitario de Toledo, Toledo, Spain

    Almudena Vicente Delgado

  10. Endocrinology & Nutrition Department, Hospital Universitario de Valladolid, Valladolid, Spain

    Emilia Gómez Hoyos

  11. Endocrinology & Nutrition Department, Hospital Universitario Rey Juan Carlos, Madrid, Spain

    Rui Ferreira

  12. General & Digestive Surgery Department, Hospital Universitario de La Princesa, Madrid, Spain

    Iñigo García Sanz

  13. Endocrinology & Nutrition Department, Hospital De Girona Doctor Josep Trueta, Girona, Spain

    Mònica Recasens Sala & Rebeca Barahona San Millan

  14. Endocrinology & Nutrition Department, Hospital Universitario Virgen de la Victoria de Málaga. IBIMA Malaga. Spain CIBEROBN, Madrid, Spain

    María José Picón César

  15. Endocrinology & Nutrition Department, Hospital Universitario Infanta Sofía, Madrid, Spain

    Patricia Díaz Guardiola

  16. Endocrinology & Nutrition Department, Clínica Universidad de Navarra, Pamplona, Spain

    Carolina M. Perdomo

  17. Endocrinology & Nutrition Department, Hospital Universitario Central de Asturias, Oviedo, Spain

    Laura Manjón-Miguélez

  18. Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Madrid, Spain

    Laura Manjón-Miguélez

  19. Endocrinology & Nutrition Department, Hospital Universitario Gregorio Marañón, Madrid, Spain

    Rogelio García Centeno & Juan Carlos Percovich

  20. Endocrinology & Nutrition Department, Hospital Reina Sofía, Córdoba, Spain

    Ángel Rebollo Román

  21. Endocrinology & Nutrition Department, Hospital Royo Villanova, Zaragoza, Spain

    Paola Gracia Gimeno

  22. Endocrinology & Nutrition Department, Complejo Universitario de Salamanca, Salamanca, Spain

    Cristina Robles Lázaro

  23. Biochemistry and Molecular Genetics Department-CDB, Hospital Clinic. IDIBAPS, CIBERehd, Barcelona, Spain

    Manuel Morales-Ruiz

  24. Endocrinology & Nutrition Department, Hospital Doce de Octubre, Madrid, Spain

    María Calatayud & Simone Andree Furio Collao

  25. Endocrinology & Nutrition Department, Hospital Universitario La Princesa, Madrid, Spain

    Miguel Antonio Sampedro Nuñez

  26. Nephrology Department, Hospital Universitario Doctor Peset, Valencia, Spain

    Verónica Escudero Quesada

  27. Endocrinology & Nutrition Department, Hospital Universitario Son Espases, Islas Baleares, Spain

    Elena Mena Ribas & Alicia Sanmartín Sánchez

  28. Endocrinology & Nutrition Department, Hospital Universitario De Albacete, Albacete, Spain

    Cesar Gonzalvo Diaz & Cristina Lamas

  29. Endocrinology & Nutrition Department, Hospital Universitario Virgen Macarena, Sevilla, Spain

    Raquel Guerrero-Vázquez & María Del Castillo Tous

  30. Endocrinology & Nutrition Department, Hospital General Universitario de Alicante, Alicante, Spain

    Joaquín Serrano Gotarredona

  31. Endocrinology & Nutrition Department, Hospital Joan XXIII, Tarragona, Spain

    Theodora Michalopoulou Alevras

  32. Internal Medicine, Hospital Universitario Infanta Leonor, Madrid, Spain

    Eva María Moya Mateo

  33. Endocrinology & Nutrition Department, Hospital Clinic. IDIPAS, Barcelona, Spain

    Felicia A. Hanzu

  34. University of Alcalá, Madrid, Spain

    Marta Araujo-Castro

Authors
  1. Paola Parra Ramírez
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Patricia Martín Rojas-Marcos
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Miguel Paja Fano
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Marga González Boillos
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Begoña Pla Peris
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Eider Pascual-Corrales
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Ana María García Cano
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Jorge Gabriel Ruiz-Sanchez
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Almudena Vicente Delgado
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Emilia Gómez Hoyos
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Rui Ferreira
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Iñigo García Sanz
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Mònica Recasens Sala
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Rebeca Barahona San Millan
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. María José Picón César
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Patricia Díaz Guardiola
    View author publications

    You can also search for this author in PubMed Google Scholar

  17. Carolina M. Perdomo
    View author publications

    You can also search for this author in PubMed Google Scholar

  18. Laura Manjón-Miguélez
    View author publications

    You can also search for this author in PubMed Google Scholar

  19. Rogelio García Centeno
    View author publications

    You can also search for this author in PubMed Google Scholar

  20. Juan Carlos Percovich
    View author publications

    You can also search for this author in PubMed Google Scholar

  21. Ángel Rebollo Román
    View author publications

    You can also search for this author in PubMed Google Scholar

  22. Paola Gracia Gimeno
    View author publications

    You can also search for this author in PubMed Google Scholar

  23. Cristina Robles Lázaro
    View author publications

    You can also search for this author in PubMed Google Scholar

  24. Manuel Morales-Ruiz
    View author publications

    You can also search for this author in PubMed Google Scholar

  25. María Calatayud
    View author publications

    You can also search for this author in PubMed Google Scholar

  26. Simone Andree Furio Collao
    View author publications

    You can also search for this author in PubMed Google Scholar

  27. Diego Meneses
    View author publications

    You can also search for this author in PubMed Google Scholar

  28. Miguel Antonio Sampedro Nuñez
    View author publications

    You can also search for this author in PubMed Google Scholar

  29. Verónica Escudero Quesada
    View author publications

    You can also search for this author in PubMed Google Scholar

  30. Elena Mena Ribas
    View author publications

    You can also search for this author in PubMed Google Scholar

  31. Alicia Sanmartín Sánchez
    View author publications

    You can also search for this author in PubMed Google Scholar

  32. Cesar Gonzalvo Diaz
    View author publications

    You can also search for this author in PubMed Google Scholar

  33. Cristina Lamas
    View author publications

    You can also search for this author in PubMed Google Scholar

  34. Raquel Guerrero-Vázquez
    View author publications

    You can also search for this author in PubMed Google Scholar

  35. María Del Castillo Tous
    View author publications

    You can also search for this author in PubMed Google Scholar

  36. Joaquín Serrano Gotarredona
    View author publications

    You can also search for this author in PubMed Google Scholar

  37. Theodora Michalopoulou Alevras
    View author publications

    You can also search for this author in PubMed Google Scholar

  38. Eva María Moya Mateo
    View author publications

    You can also search for this author in PubMed Google Scholar

  39. Felicia A. Hanzu
    View author publications

    You can also search for this author in PubMed Google Scholar

  40. Marta Araujo-Castro
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Marta Araujo-Castro.

Ethics declarations

Conflict of interest

The authors declare no competing interests.

Ethical approval

The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Ethics Committee of the Hospital Universitario Ramón y Cajal. Madrid. Spain (approval date: 10th November 2020, code: ACTA 401).

Informed consent

Patient consent was waived due to the retrospective nature of the study. Only for patients who continued follow-up or prospectively included the informed consent was requested.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Parra Ramírez, P., Martín Rojas-Marcos, P., Paja Fano, M. et al. Is adrenal venous sampling always necessary to differentiate between unilateral and bilateral primary aldosteronism? Lesson from the SPAIN-ALDO register. Endocrine 84, 683–693 (2024). https://doi.org/10.1007/s12020-023-03609-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12020-023-03609-y

Keywords

Search

Navigation