Saline suppression to distinguish the primary aldosteronism subtype: a diagnostic study
Authors' conclusion
In patients undergoing the recumbent SST, a post-saline PAC <300 pmol L-1 together with a reduction in ARR can predict bilateral PA with high specificity and may allow targeted treatment to be commenced without AVS in up to a third of patients.
Study context
- Population
- Patients with primary aldosteronism (PA) who underwent recumbent saline suppression test (SST) and adrenal vein sampling (AVS), in Australia, China and JapanAustralian, Chinese and Japanese cohorts
- Participants
- 55 / 106 / 105
- Comparison
- Post-saline plasma aldosterone concentration (PAC) <300 pmol L-1 plus aldosterone-to-renin ratio (ARR) reduction following recumbent SST, for predicting bilateral PA (AVS reference)
- Australiann = 55
- Chinesen = 106
- Japanesen = 105
- Outcome
- Specificity of PAC <300 pmol L-1 plus ARR reduction after recumbent SST for predicting bilateral PA
Methodological detailsinternational, multi-centre, validation cohorts
- International
- Multi-centre
- Validation cohorts
Performance
As reported in the abstract
Specificity for predicting bilateral PA
| Test or model | Specificity |
|---|---|
| Australian | 88.2% |
| Chinese | 97.0% |
| Japanese | 100.0% |
Specificity
Australian88.2%
Chinese97.0%
Japanese100.0%
Further findings
- Proportion of patients with PA who could bypass AVS and proceed directly to medical treatment
- 22%-38%
Original publication
Saline suppression to distinguish the primary aldosteronism subtype: a diagnostic study. Eur J Endocrinol. Published 10 January 2023. doi:10.
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