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Confirmatory Testing for Primary Aldosteronism

  • Matthias Haase
  • Matthias Gruber
  • Xing Gao
  • Oliver Vonend
  • Holger S. Willenberg
Chapter

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.

Keywords

Hypertension Adrenal Aldosterone Fludrocortisone Sodium Saline Captopril Urine Dexamethasone Cortisol 

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Matthias Haase
    • 1
    • 2
  • Matthias Gruber
    • 2
  • Xing Gao
    • 3
  • Oliver Vonend
    • 4
  • Holger S. Willenberg
    • 5
    • 6
  1. 1.Department of Endocrinology and DiabetesHeinrich-Heine UniversityDuesseldorfGermany
  2. 2.Department of Medicine IIITechnical UniversityDresdenGermany
  3. 3.Department of NephrologyHeinrich-Heine UniversityDuesseldorfGermany
  4. 4.Department of NephrologyGerman Clinic of DiagnosticsyWiesbadenGermany
  5. 5.Division of Endocrinology and MetabolismUniversity of RostockRostockGermany
  6. 6.Department of Endocrinology and DiabetesUniversity Hospital DuesseldorfDüsseldorfGermany

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