Primary hyperaldosteronism diagnostic study of choice

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Diagnostic study of choice

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Overview

Fludrocortisone supression test (FST) is the gold standard test for the diagnosis of primary hyperaldosteronism. A value of >6 ng/dl and simultaneous plasma renin-aldosterone ratio (PRA) <1.0 ng/ml/hour, confirm primary hyperaldosteronism.

Diagnostic study of choice

Fludrocortisone suppression test (FST)

  • Patient is given a synthetic mineralocorticoid (9-alpha-fludrocortisone acetate 0.1 mg every six hours) and sodium chloride (slow-release sodium 30 mmol (1.75 g) three times daily).
  • Plasma aldosterone level is measured in the morning after four days of administration.
  • A value of >6 ng/dl and simultaneous PRA levels <1.0 ng/ml/hour, confirm primary hyperaldosteronism.

References

  1. Djajadiningrat-Laanen SC, Galac, Boevé MH, Boroffka SA, Naan EC, IJzer J, Kooistra HS (2013). "Evaluation of the oral fludrocortisone suppression test for diagnosing primary hyperaldosteronism in cats". J. Vet. Intern. Med. 27 (6): 1493–9. PMID 24627898.
  2. Willenberg HS, Vonend O, Schott M, Gao X, Blondin D, Saleh A, Rump LC, Scherbaum WA (2012). "Comparison of the saline infusion test and the fludrocortisone suppression test for the diagnosis of primary aldosteronism". Horm. Metab. Res. 44 (7): 527–32. doi:10.1055/s-0032-1314786. PMID 22689209.
  3. Lund JO, Nielsen MD (1980). "Fludrocortisone suppression test in normal subjects, in patients with essential hypertension and in patients with various forms of aldosteronism". Acta Endocrinol. 93 (1): 100–7. PMID 6986736.