scholarly journals Diagnosing unilateral primary aldosteronism - comparison of a clinical prediction score, computed tomography and adrenal venous sampling

2013 ◽  
Vol 81 (1) ◽  
pp. 25-30 ◽  
Author(s):  
W. C. Candy Sze ◽  
Lip Min Soh ◽  
Jeshen H. Lau ◽  
Rodney Reznek ◽  
Anju Sahdev ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Primary Aldosteronism ◽  
Prediction Score ◽  
Adrenal Venous Sampling ◽  
Clinical Prediction ◽  
Venous Sampling

scholarly journals Age Below 40 or a Recently Proposed Clinical Prediction Score Cannot Bypass Adrenal Venous Sampling in Primary Aldosteronism

2014 ◽  
Vol 99 (6) ◽  
pp. E1035-E1039 ◽  
Author(s):  
Anna Riester ◽  
Evelyn Fischer ◽  
Christoph Degenhart ◽  
Maximilian F. Reiser ◽  
Martin Bidlingmaier ◽  
...  
Keyword(s):  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Serum Potassium ◽  
Primary Aldosteronism ◽  
Filtration Rate ◽  
Prediction Score ◽  
Adrenal Venous Sampling ◽  
Young Cohort ◽  
Clinical Prediction ◽  
Venous Sampling

Context: Adrenal venous sampling (AVS) is used to distinguish bilateral from unilateral primary aldosteronism (PA). Due to its limited availability, clinical prediction scores have been proposed to diagnose unilateral disease without AVS. Objective: Our goal was to test 2 recently proposed predictors of unilateral PA: 1) a clinical prediction score using imaging, serum potassium, and glomerular filtration rate and 2) the combination of visible unilateral adenoma on imaging and age <40 years. Design and Setting: We used the data of all patients with PA of the prospective German Conn's Registry treated in Munich and Berlin since 2008. Patients and Intervention: Of 205 patients with PA, 194 had a successful AVS and were included. Main Outcome Measures: Parameters were compared between patients with lateralized and nonlateralized AVS. Specificity and sensitivity of the proposed predictors were calculated. Results: A total of 130 patients (67%) had unilateral PA according to AVS. Patients with unilateral PA showed a significantly lower estimated glomerular filtration rate compared with patients with bilateral disease (P < .05). The cohorts differed significantly in potassium supplementation, serum potassium, baseline and post-saline plasma aldosterone, baseline aldosterone to renin ratio, and adenoma in imaging. The proposed prediction score had a sensitivity of 46% (58 of 127) and a specificity of 80% (53 of 66). In patients below 40 years (n = 28), the prediction score achieved a specificity of 100%; however, relying only on imaging in this young cohort, the specificity dropped to 83%. Conclusions: The suggested prediction score has high accuracy only in young patients but cannot substitute for AVS in the elderly.

scholarly journals Non-stimulated adrenal venous sampling using Dyna computed tomography in patients with primary aldosteronism

2016 ◽  
Vol 6 (1) ◽  
Author(s):  
Chin-Chen Chang ◽  
Bo-Ching Lee ◽  
Kao-Lang Liu ◽  
Yeun-Chung Chang ◽  
Vin-Cent Wu ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Primary Aldosteronism ◽  
Adrenal Venous Sampling ◽  
Venous Sampling

scholarly journals Computed Tomography and Adrenal Venous Sampling in the Diagnosis of Unilateral Primary Aldosteronism

Hypertension ◽  
2018 ◽  
Vol 72 (3) ◽  
pp. 641-649 ◽  
Author(s):  
Tracy A. Williams ◽  
Jacopo Burrello ◽  
Leonardo A. Sechi ◽  
Carlos E. Fardella ◽  
Joanna Matrozova ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Primary Aldosteronism ◽  
Adrenal Venous Sampling ◽  
Venous Sampling

scholarly journals A Clinical Prediction Score to Diagnose Unilateral Primary Aldosteronism

2012 ◽  
Vol 97 (10) ◽  
pp. 3530-3537 ◽  
Author(s):  
Elselien M. Küpers ◽  
Laurence Amar ◽  
Alain Raynaud ◽  
Pierre-François Plouin ◽  
Olivier Steichen
Keyword(s):  
Glomerular Filtration Rate ◽  
Confidence Interval ◽  
Glomerular Filtration ◽  
Serum Potassium ◽  
Primary Aldosteronism ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Adrenal Venous Sampling ◽  
Clinical Prediction ◽  
Venous Sampling

Abstract Context: Adrenal venous sampling is recommended to assess whether aldosterone hypersecretion is lateralized in patients with primary aldosteronism. However, this procedure is invasive, poorly standardized, and not widely available. Objective: Our goal was to identify patients' characteristics that can predict unilateral aldosterone hypersecretion in some patients who could hence bypass adrenal venous sampling before surgery. Design and Setting: A cross-sectional diagnostic study was performed from February 2009 to July 2010 at a single center specialized in hypertension care. Patients: A total of 101 consecutive patients with primary aldosteronism who underwent adrenal venous sampling participated in the study. The autonomy of aldosterone hypersecretion was assessed with the saline infusion test. Intervention: Adrenal venous sampling was performed without ACTH infusion but with simultaneous bilateral sampling. Main Outcome Measures: Variables independently associated with a lateralized adrenal venous sampling in multivariate logistic regression were used to derive a clinical prediction rule. Results: Adrenal venous sampling was successful in 87 patients and lateralized in 49. All 26 patients with a typical Conn's adenoma plus serum potassium of less than 3.5 mmol/liter or estimated glomerular filtration rate of at least 100 ml/min/1.73 m2 (or both) had unilateral primary aldosteronism; this rule had 100% specificity (95% confidence interval, 91–100) and 53% sensitivity (95% confidence interval, 38–68). Conclusions: If our results are validated on an independent sample, adrenal venous sampling could be omitted before surgery in patients with a typical Conn's adenoma if they meet at least one of two supplementary biochemical characteristics (serum potassium <3.5 mmol/liter or estimated glomerular filtration rate ≥100 ml/min/1.73 m2).

Primary aldosteronism subtype discordance between computed tomography and adrenal venous sampling

2019 ◽  
Vol 42 (12) ◽  
pp. 1942-1950 ◽  
Author(s):  
Daisuke Aono ◽  
Mitsuhiro Kometani ◽  
Shigehiro Karashima ◽  
Mikiya Usukura ◽  
Yuko Gondo ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Primary Aldosteronism ◽  
Adrenal Venous Sampling ◽  
Venous Sampling
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