A 120-Minute Saline Infusion Test for the Confirmation of Primary Aldosteronism: A Pilot Study.
Am J Hypertens
; 37(6): 415-420, 2024 05 15.
Article
em En
| MEDLINE
| ID: mdl-38374690
ABSTRACT
BACKGROUND:
The saline infusion test (SIT) to confirm primary aldosteronism requires infusing 2 L of normal saline over 240 minutes. Previous studies raised concerns regarding increased blood pressure and worsening hypokalemia during SIT. We aimed to evaluate the diagnostic applicability of a SIT that requires 1 L of saline infusion over 120 minutes.METHODS:
A cross-sectional study, including all patients in a large medical center who underwent SIT from 1 January 2015 to 30 April 2023. Blood samples were drawn for baseline renin and aldosterone (tâ =â 0) after 2 hours (tâ =â 120 min) and after 4 hours (tâ =â 240 min) of saline infusion. We used ROC analysis to evaluate the sensitivity and specificity of various aldosterone cut-off values at tâ =â 120 to confirm primary aldosteronism.RESULTS:
The final analysis included 62 patients. A ROC analysis yielded 97% specificity and 90% sensitivity for a plasma aldosterone concentration (PAC) of 397 pmol/L (14 ng/dL) at tâ =â 120 to confirm primary aldosteronism, and an area under the curve of 0.97 (95% CI [0.93, 1.00], Pâ <â 0.001). Almost half (44%) of the patients did not suppress PAC below 397 pmol/L (14 ng/dL) at tâ =â 120. Of them, only one (4%) patient suppressed PAC below 276 pmol/L (10 ng/dL) at tâ =â 240. Mean systolic blood pressure increased from 140.1â ±â 21.3 mm Hg at tâ =â 0 to 147.6â ±â 14.5 mm Hg at tâ =â 240 (Pâ =â 0.011).CONCLUSIONS:
A PAC of 397 pmol/L (14 ng/dL) at tâ =â 120 has high sensitivity and specificity for primary aldosteronism confirmation.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Renina
/
Aldosterona
/
Solução Salina
/
Hiperaldosteronismo
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Israel