scholarly journals HIGH LEVEL OF PLASMA ALDOSTERONE AFTER SALINE INFUSION TEST IN COMBINATION WITH FINDING OF ADRENAL NODE ON CT SCAN CAN PREDICT ALDOSTERONE-PRODUCING ADENOMA MORE PRECISE THAN FINDING OF NODE ALONE

2021 ◽  
Vol 39 (Supplement 1) ◽  
pp. e91
Author(s):  
Robert Holaj ◽  
Jan Kvasnicka ◽  
Jan Rosa ◽  
Tomas Zelinka ◽  
Ondrej Petrak ◽  
...  
Keyword(s):  
Ct Scan ◽  
Plasma Aldosterone ◽  
Saline Infusion ◽  
Infusion Test ◽  
Aldosterone Producing Adenoma ◽  
High Level

scholarly journals MON-192 Comparison of the Seated and Recumbent Saline Infusion Test for the Diagnosis of Primary Aldosteronism in Chinese Population

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Dan Zhang ◽  
Tao Chen ◽  
Haoming Tian ◽  
Yuanmei Li ◽  
Dan Mo ◽  
...  
Keyword(s):  
Primary Aldosteronism ◽  
Operating Characteristic ◽  
Saline Infusion ◽  
Youden Index ◽  
Infusion Test ◽  
Subtype Classification ◽  
Aldosterone Producing Adenoma ◽  
Preliminary Study ◽  
Better Than

Abstract Background: None of the diagnostic tests for primary aldosteronism (PA) are ideal according to the current literature. In a preliminary study, the seated saline infusion test (SSIT) was more sensitive than the recumbent saline infusion test (RSIT) for the diagnosis and subtype classification of PA. However, it is unclear whether the SSIT is suitable for Chinese PA patients. Objective: We prospectively investigated the accuracy of the seated saline infusion test (SSIT) in 113 patients with hypertension (including 93 PA and 20 essential hypertension (EH) patients) in the Department of Endocrinology and Metabolism. Approach and Results: Each patient underwent an recumbent saline infusion test (RSIT) and seated saline infusion test (SSIT). The accuracy of the SSIT for a confirmative primary aldosteronism (PA) diagnosis and subtype classification was evaluated and compared with the RSIT. The area under the receiver operating characteristic (ROC) curve (AUC) of aldosterone for the SSIT was significantly greater than that for the RSIT (0.945±0.0199 vs 0.828±0.0404; P<0.05). The ROC analysis showed that the optimal plasma aldosterone cutoff values were 12.94 ng/dl for the SSIT (sensitivity 86.02%, specificity 95%; Youden index (YI)=0.810) and 12.04 ng/dl for the RSIT (sensitivity 83.15%, specificity 57%; Youden index (YI)=0.401). The optimal aldosterone concentration cutoff value for classifying aldosterone-producing adenoma (APA) and idiopathic hyperaldosteronism (IHA) was 18.12 ng/dl for the SSIT (sensitivity 73.5%, specificity 79.5%). No patients experienced adverse events during the SSIT. Conclusions: The SSIT was safe and convenient for PA diagnosis. The accuracy of the SSIT for a confirmatory diagnosis of PA was better than that of the RSIT. The SSIT is a reliable alternative for PA confirmation in Chinese individuals.

scholarly journals Comparison of the Captopril and the Saline Infusion Test for Excluding Aldosterone-Producing Adenoma

Hypertension ◽  
2007 ◽  
Vol 50 (2) ◽  
pp. 424-431 ◽  
Author(s):  
Gian Paolo Rossi ◽  
Anna Belfiore ◽  
Giampaolo Bernini ◽  
Giovambattista Desideri ◽  
Bruno Fabris ◽  
...  
Keyword(s):  
Saline Infusion ◽  
Infusion Test ◽  
Aldosterone Producing Adenoma

Prospective evaluation of the saline infusion test for excluding primary aldosteronism due to aldosterone-producing adenoma

2007 ◽  
Vol 25 (7) ◽  
pp. 1433-1442 ◽  
Author(s):  
Gian Paolo Rossi ◽  
Anna Belfiore ◽  
Giampaolo Bernini ◽  
Giovambattista Desideri ◽  
Bruno Fabris ◽  
...  
Keyword(s):  
Primary Aldosteronism ◽  
Saline Infusion ◽  
Infusion Test ◽  
Prospective Evaluation ◽  
Aldosterone Producing Adenoma

scholarly journals The saline infusion test for primary aldosteronism: implications of immunoassay inaccuracy

2021 ◽  
Author(s):  
Graeme Eisenhofer ◽  
Max Kurlbaum ◽  
Mirko Peitzsch ◽  
Georgiana Constantinescu ◽  
Hanna Remde ◽  
...  
Keyword(s):  
Mass Spectrometry ◽  
Primary Aldosteronism ◽  
Tertiary Care ◽  
Plasma Aldosterone ◽  
Saline Infusion ◽  
Simple Solution ◽  
Infusion Test ◽  
Aldosterone Production ◽  
Tertiary Care Centers ◽  
Positive Results

Abstract Context Diagnosis of primary aldosteronism (PA) for many patients depends on positive results for the saline infusion test (SIT). Plasma aldosterone is often measured by immunoassays, which can return inaccurate results. Objective Establish whether differences in aldosterone measurements by immunoassay versus mass spectrometry (MS) might impact confirmatory testing for PA. Methods This study, involving 240 patients tested using the SIT at five tertiary-care centers, assessed discordance between immunoassay and MS-based measurements of plasma aldosterone. Results Plasma aldosterone measured by Liaison and iSYS immunoassays were respectively 86% and 58% higher than by MS. With an immunoassay-based SIT cut-off for aldosterone of 170 pmol/L, 78 and 162 patients had respective negative and positive results. All former patients had MS-based measurements of aldosterone <117 pmol/L, below MS-based cutoffs of 162 pmol/L. Among the 162 patients with pathogenic SIT results, MS returned non-pathologic results in 62, including 32 under 117 pmol/L. Repeat measurements by an independent MS method confirmed non-pathogenic results in 53 patients with discordant results. Patients with discordant results showed a higher (P<0.0001) prevalence of non-lateralized than lateralized adrenal aldosterone production than patients with concordant results (83%vs28%). Among patients with non-lateralized aldosterone production, 66% had discordant results. Discordance was more prevalent for the Liaison than iSYS immunoassay (32%vs16% P=0.0065) and was eliminated by plasma purification to remove interferents. Conclusions These findings raise concerns about the validity of immunoassay-based diagnosis of PA in over 60% of patients with presumed bilateral disease. We provide a simple solution to minimize immunoassay inaccuracy-associated misdiagnosis of PA.

scholarly journals Comparison of the Captopril and the Saline Infusion Test for Excluding Aldosterone-Producing Adenoma

2007 ◽  
Vol 14 (3) ◽  
pp. 145-196
Author(s):  
G P. Rossi ◽  
A Belfiore ◽  
G Bernini ◽  
G Desideri ◽  
B Fabris ◽  
...  
Keyword(s):  
Saline Infusion ◽  
Infusion Test ◽  
Aldosterone Producing Adenoma

scholarly journals Plasma Aldosterone After Seated Saline Infusion Test Outperforms Captopril Test at Predicting Clinical Outcomes After Adrenalectomy for Primary Aldosteronism

2019 ◽  
Vol 32 (11) ◽  
pp. 1066-1074
Author(s):  
Che-Hsiung Wu ◽  
Vincent Wu ◽  
Ya-Wen Yang ◽  
Yen-Hung Lin ◽  
Shao-Yu Yang ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Primary Aldosteronism ◽  
Clinical Success ◽  
Final Analysis ◽  
Plasma Aldosterone ◽  
Saline Infusion ◽  
Infusion Test ◽  
Confirmatory Tests ◽  
Favorable Clinical Outcome ◽  
Captopril Test

Abstract OBJECTIVE The saline infusion test (SIT) and the captopril test (CT) are widely used as confirmatory tests for primary aldosteronism (PA). We hypothesized that post-SIT and post-CT plasma aldosterone concentrations (PAC) indicate the severity of aldosterone-producing adenoma (APA) and might predict clinical outcome. METHODS We recruited 216 patients with APA in the Taiwan Primary Aldosteronism Investigation (TAIPAI) registry who received both seated SIT and CT as confirmatory tests. The data of 143 patients who underwent adrenalectomy with complete follow-up after diagnosis were included in the final analysis. We determined the proportion of patients achieving clinical success in accordance with the Primary Aldosteronism Surgical Outcome consensus. Logistic regression analysis was conducted to identify preoperative factors associated with cure of hypertension. RESULTS Complete clinical success was achieved in 48 (33.6%) patients and partial clinical success in 59 (41.2%) patients; absent clinical success was seen in 36 (25.2%) of 143 patients. Post-SIT PAC but not post-CT PAC was independently associated with clinical outcome. Higher levels of post-SIT PAC had a higher likelihood of clinical benefit (complete plus partial clinical success; odds ratio = 1.04 per ng/dl increase, 95% confidence interval = 1.01, 1.06; P = 0.004). Patients with post-SIT PAC > 25 ng/dl were more likely to have a favorable clinical outcome after adrenalectomy. This cutoff value translated into a positive predictive value of 86.0%. CONCLUSIONS We suggest that post-SIT PAC is a better predictor than post-CT PAC for clinical success in PA post adrenalectomy.

scholarly journals Evaluation of various confirmatory tests for the diagnosis of aldosterone-producing adenoma

2020 ◽  
Vol 21 (2) ◽  
pp. 147032032091961
Author(s):  
Satoshi Kidoguchi ◽  
Naoki Sugano ◽  
Ruri Kawauchi ◽  
Daisuke Nakashima ◽  
Naomi Hayashi-Ishikawa ◽  
...  
Keyword(s):  
Adrenocorticotropic Hormone ◽  
Challenge Test ◽  
Plasma Aldosterone ◽  
Stimulation Test ◽  
Saline Infusion ◽  
Infusion Test ◽  
Venous Sampling ◽  
Plasma Aldosterone Concentration ◽  
Hormone Stimulation ◽  
Confirmatory Tests

Introduction: Adrenal venous sampling is useful for discriminating unilateral and bilateral hypersecretion in patients with primary aldosteronism, but it is relatively invasive. To determine the site of hypersecretion more non-invasively, we evaluated predictors of unilateral hypersecretion. Materials and methods: We evaluated the baseline characteristics and the results of confirmatory tests of 123 patients with primary aldosteronism who underwent adrenal venous sampling. Results: Unilateral hypersecretion was identified in 22.0%. The plasma aldosterone concentration and aldosterone–renin ratio were significantly higher and serum potassium concentration and plasma renin activity were significantly lower in patients with unilateral hypersecretion. Plasma aldosterone concentrations after captopril challenge test, saline infusion test and rapid adrenocorticotropic hormone stimulation test were significantly higher among patients with unilateral hypersecretion. The plasma aldosterone concentration reduction ratio in saline infusion test and plasma aldosterone concentration elevation ratio during rapid adrenocorticotropic hormone stimulation test were significantly higher in patients with unilateral hypersecretion. However, areas under the curve for these parameters were not superior to the values after confirmatory tests. Conclusions: The plasma aldosterone concentration values after captopril challenge test, saline infusion test and rapid adrenocorticotropic hormone stimulation test were useful for identifying patients with unilateral hypersecretion. However, value changes or ratios during confirmatory tests are less useful for this aim.

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