Intra-individual Variability of Serum Aldosterone and Implications for Primary Aldosteronism Screening
An erratum to this article was published (J Clin Endocrinol Metab, 13 Apr 2023 ↗)
Authors' conclusion
Aldosterone concentrations had a high CV in PA patients, which results in an elevated rate of false negatives in a single screening for PA. Therefore, PA screening should be based on at least 2 screenings with concomitant aldosterone and renin measurements.
Study context
- Population
- Patients with confirmed primary aldosteronism (PA) and at least 2 screenings; aldosterone and DRC measured by the same chemiluminescence assays671 measurements
- Participants
- 216 patients
- Outcome
- Intra-individual CV of aldosterone and aldosterone to direct renin concentration ratio (A/DRC) and its impact on PA screening
Main finding
As reported in the abstract
Median intra-individual coefficient of variation (CV) of aldosterone
26.8%
Median intra-individual CV of A/DRC
26.7%
Observational data: associations, not effects.
Further findings
Aldosterone <15 ng/dL
- At least one aldosterone level <15 ng/dL
- Almost 40%
- At least 2 aldosterone levels <15 ng/dL
- 19.9%
- Mean aldosterone levels <15 ng/dL
- 16.2%
False negative rates for PA screening with aldosterone cutoff of 10 ng/dL
- Single aldosterone measurement
- 14.3%
- 2 aldosterone measurements
- 4.6%
- Mean aldosterone levels
- 2.3%
True positive rate of minimum aldosterone thresholds
- 10 ng/dL
- 85.7%
- 15 ng/dL
- 61.6%
True positive rate of A/DRC >2 ng/dL/µIU/mL for PA diagnosis
- Based on 1 assessment
- 94.4%
- Based on 2 assessments
- 98.4%
Determinants of CV
- CV of aldosterone and A/DRC not affected by sex, interfering antihypertensive medications, PA lateralization, hypokalemia, age, and number of hormone measurements
Original publication
Composed by AI from the published abstract and checked against it. How Briefs are made →