Urinary aldosterone analyzed by LC-MS/MS vs immunoassay for diagnosis of primary aldosteronism
Authors' conclusion
24hr-UAldo-LCMS in the setting of 24hr-UNa ≥190 mmol/24 h can diagnose PA with high sensitivity and specificity, at lower cut-offs than 24hr-UAldo-IA.
Study context
- Population
- Patients with hypertension with elevated plasma aldosterone-renin ratio and/or adrenalectomy for unilateral primary aldosteronism (PA), 24hr-UNa measured and seated saline suppression test (SSST) performed, off interfering medications, unrestricted dietary sodium; tertiary centre, 5 years
- Participants
- 182 vs 121
- Comparison
- 24hr-UAldo by LC-MS/MS vs immunoassay for diagnosing PA
- 24hr-UAldo-LCMSn = 182
- 24hr-UAldo-IAn = 121reference
- Outcome
- Diagnosis of PA when 24hr-UNa ≥190 mmol/24 h
Methodological detailsprospectively-collected samples, tertiary centre, SSST as reference test
- Prospectively-collected samples
- Tertiary centre
- SSST as reference test
Performance
As reported in the abstract
| Test or model | Cut-off | Sensitivity | Specificity | AUC |
|---|---|---|---|---|
| 24hr-UAldo-LCMS | ≥23.5 nmol/24 h | 92.1% | 82.6% | 0.946 |
| 24hr-UAldo-IA | ≥24.5 nmol/24 h | 92.3% | 66.7% | 0.81 |
Cut-off
24hr-UAldo-LCMS≥23.5 nmol/24 h
24hr-UAldo-IA≥24.5 nmol/24 h
Sensitivity
24hr-UAldo-LCMS92.1%
24hr-UAldo-IA92.3%
Specificity
24hr-UAldo-LCMS82.6%
24hr-UAldo-IA66.7%
AUC
24hr-UAldo-LCMS0.946
24hr-UAldo-IA0.81
Further findings
24hr-UAldo-LCMS by SSST result · positive SSST n = 127; negative SSST n = 55
P < 0.05
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Urinary aldosterone analyzed by LC-MS/MS vs immunoassay for diagnosis of primary aldosteronism. J Clin Endocrinol Metab. Published 26 August 2026. doi:10.
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