Assessment of serum sodium to urinary sodium divided by (serum potassium)² to urinary potassium as a screening tool for primary aldosteronism

2010 ◽  
Vol 41 (2) ◽  
pp. 189-194 ◽  
Author(s):  
Olivier Steichen ◽  
Anne Blanchard ◽  
Pierre-François Plouin
Keyword(s):  
Serum Sodium ◽  
Serum Potassium ◽  
Primary Aldosteronism ◽  
Screening Tool ◽  
Urinary Sodium ◽  
Urinary Potassium

scholarly journals Aldosterone-Mediated Sodium Retention Is Reflected by the Serum Sodium to Urinary Sodium to (Serum Potassium)2 to Urinary Potassium (SUSPPUP) Index

Diagnostics ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. 545
Author(s):  
Evelien Kanaan ◽  
Matthias Haase ◽  
Oliver Vonend ◽  
Martin Reincke ◽  
Matthias Schott ◽  
...  
Keyword(s):  
Serum Sodium ◽  
Serum Potassium ◽  
Reference Group ◽  
Urinary Sodium ◽  
Sodium Retention ◽  
Fasting State ◽  
Urinary Potassium ◽  
Aldosterone To Renin Ratio ◽  
Sodium And Potassium ◽  
Parallel Measurements

The serum sodium to urinary sodium ratio divided by the (serum potassium)2 to urinary potassium ratio (SUSPPUP formula) reflects aldosterone action. We here prospectively investigated into the usefulness of the SUSPPUP ratio as a diagnostic tool in primary hyperaldosteronism. Parallel measurements of serum and urinary sodium and potassium concentrations (given in mmol/L) in the fasting state were done in 225 patients. Of them, 69 were diagnosed with primary aldosteronism (PA), 102 with essential hypertension (EH), 26 with adrenal insufficiency (AI) and 28 did not suffer from the above-mentioned disorders and were assigned to the reference group (REF). The result of the SUSPPUP formula was highest in the PA group (7.4, 4.2–12.3 L/mmol), followed by EH (3.2, 2.3–4.3 L/mmol), PA after surgery (3.9, 3.0–6.0 L/mmol), REF (3.4 ± 1.4 L/mmol) and AI (2.9 +/− 1.2 L/mmol). The best sensitivity in distinguishing PA from EH was reached by multiplication of the aldosterone to renin-ratio (ARR) with the SUSPPUP formula (92.7% at a cut off > 110 L/mmol), highest specificity was reached by the SUSPPUP determinations (87.2%). The integration of the SUSPPUP ratio into the ARR helps to improve the diagnosis of hyperaldosteronism substantially.

scholarly journals Urinary sodium potassium ratio is associated with clinical success after adrenalectomy in patients with unilateral primary aldosteronism

2021 ◽  
Vol 12 ◽  
pp. 204062232199027
Author(s):  
Ming-Jse Lee ◽  
Chiao-Yin Sun ◽  
Ching-Chu Lu ◽  
Yuan-Shian Chang ◽  
Heng-Chih Pan ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Serum Potassium ◽  
Primary Aldosteronism ◽  
Clinical Success ◽  
Plasma Aldosterone ◽  
Urinary Sodium ◽  
Dietary Sodium ◽  
Sodium Potassium ◽  
Inflammatory Status ◽  
Lower Urinary

Background: The urinary sodium potassium (NaK) ratio is associated with dietary sodium and potassium intake and blood pressure, and it also reflects the activity of aldosterone. Herein we evaluated the value of the urinary NaK ratio in predicting the surgical outcomes of patients with unilateral primary aldosteronism (uPA). Methods: This non-concurrent prospective cohort study was conducted from 2011 to 2017 and included 241 uPA patients who had undergone adrenalectomy. Predictors of successful clinical outcomes were analyzed using logistic regression. Results: Among the 241 uPA patients, 197 (81.7%) achieved clinical complete or partial success. A urinary sodium potassium ratio <3 (odds ratio (OR): 2.5; 95% confidence interval (CI): 1.2–5.4; p = 0.015), body mass index <25 kg/m2 (OR: 2.82; 95% CI: 1.31–6.06; p = 0.008), renin <1 ng/mL/h (OR: 2.51; 95% CI: 1.01–6.21; p = 0.047) and mean preoperative blood pressure >115 mmHg (OR: 5.02; 95% CI: 2.10–11.97; p < 0.001) could predict clinical success after adrenalectomy. Furthermore, higher pre-treatment plasma aldosterone (OR: 1.014; 95% CI 1.005–1.024; p = 0.002) or lower serum potassium (OR: 0.523; 95% CI: 0.328–0.836; p = 0.007) were correlated with lower urinary NaK ratio (<3), and log urinary NaK ratio was positively correlated with serum C-reactive protein ( β value 2.326; 95% CI 0.029–4.623; p = 0.047). Conclusions: uPA patients with a lower urinary NaK ratio, due to high plasma aldosterone and low serum potassium concentrations, were more likely to have clinical success after adrenalectomy. uPA patients with a higher urinary NaK ratio were associated with more severe inflammatory status, and possibly more resistant hypertension post-operatively.

Combined Treatment of Severe Hyponatremia Due to Inappropriate Antidiuretic Hormone Secretion

PEDIATRICS ◽  
1982 ◽  
Vol 69 (5) ◽  
pp. 610-612
Author(s):  
Zvi Weizman ◽  
Kalman Goitein ◽  
Yair Amit ◽  
Uri Wald ◽  
Heddy Landau
Keyword(s):  
Antidiuretic Hormone ◽  
Hypertonic Saline ◽  
Serum Sodium ◽  
Combined Treatment ◽  
Hormone Secretion ◽  
Urinary Sodium ◽  
Surgical Removal ◽  
Hypertonic Saline Solution ◽  
Deoxycorticosterone Acetate ◽  
Low Serum

A 6-year-old girl developed generalized seizures followed by coma, five days after surgical removal of a craniopharyngioma. Low serum sodium levels and low serum osmolality with inappropriately high urinary sodium output confirmed the diagnosis of inappropriate antidiuretic hormone (ADH) secretion. Treatment with 3% hypertonic saline solution and repeated doses of furosemide (1 mg/kg) improved her clinical condition; serum sodium levels, however, rose slowly and urinary excretion remained high. Deoxycorticosterone acetate (DOCA), 4 mg/sq m/day, was added to the above regimen. A striking clinical improvement was noted. Serum sodium levels returned to normal with a concomitant sharp decline in urinary sodium output. The clinical course of this patient demonstrates the efficacy of the addition of deoxycorticosterone acetate to hypertonic saline and furosemide in the treatment of severe, lifethreatening hyponatremia due to the syndrome of inappropriate antidiuretic hormone seretion.

Aldosterone and ADH response to heat and dehydration in cattle

1980 ◽  
Vol 48 (2) ◽  
pp. 249-255 ◽  
Author(s):  
F. D. El-Nouty ◽  
I. M. Elbanna ◽  
T. P. Davis ◽  
H. D. Johnson
Keyword(s):  
Plasma Protein ◽  
Serum Sodium ◽  
Urine Output ◽  
Heat Exposure ◽  
Urinary Sodium Excretion ◽  
Inhibitory Effect ◽  
Significant Rise ◽  
Plasma Aldosterone ◽  
Total Plasma Protein ◽  
Urinary Potassium

The effect of heat (35 degrees C) and dehydration under heat (30 h) on plasma levels of antidiuretic hormone (ADH) and aldosterone was studied on four nonpregnant dry Holstein cows. Heat exposure caused a rapid significant rise in plasma ADH without significant changes in hematocrit (Hct), small but significant increase in urine output and a significant reduction in total plasma protein. Dehydration under heat caused a sharp increase in ADH levels associated with a significant decrease in urine output and a significant increase in plasma protein, blood Hct, and serum osmolality. A significant reduction in plasma aldosterone level was observed after 24 h of heat exposure. This was associated with a slight rise in urinary sodium excretion and a significant reduction in serum sodium. Both serum and urinary potassium concentrations were significantly lower under heat. Dehydration resulted in a slow rise in aldosterone but did not reach thermoneutral level. This is probably due to the inhibitory effect of higher serum sodium observed during dehydration on plasma aldosterone secretion. The rise in ADH and decrease in aldosterone during heat exposure may explain why cattle are one of the few species that do not concentrate urine during heat exposure.

scholarly journals Ratio of Urinary Potassium to Urinary Sodium and the Potassium and Edema Status in Nephrotic Syndrome

2011 ◽  
Vol 50 (6) ◽  
pp. 551-555 ◽  
Author(s):  
Hiroshi Matsumoto ◽  
Yoshitaka Miyaoka ◽  
Tomonari Okada ◽  
Yume Nagaoka ◽  
Toshikazu Wada ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Urinary Sodium ◽  
Urinary Potassium

A14761 Random 24-hour urinary sodium and aldosterone excretion in hypertensive patients may indicate underlying primary aldosteronism

2018 ◽  
Vol 36 ◽  
pp. e219
Author(s):  
Jenny Sung Won Yun ◽  
Kay Weng Choi ◽  
StellaMay Gwini ◽  
Peter Fuller ◽  
Jun Yang ◽  
...  
Keyword(s):  
Primary Aldosteronism ◽  
Urinary Sodium ◽  
Hypertensive Patients

scholarly journals Aldosterone to Renin Ratio as Screening Tool in Primary Aldosteronism

2018 ◽  
Vol 127 (02/03) ◽  
pp. 84-92
Author(s):  
Katharina Schilbach ◽  
Riia Junnila ◽  
Martin Bidlingmaier
Keyword(s):  
Primary Aldosteronism ◽  
Screening Test ◽  
Screening Tool ◽  
Secondary Hypertension ◽  
Hypertensive Patients ◽  
Assay Methods ◽  
Aldosterone To Renin Ratio

AbstractPrimary aldosteronism (PA) is a severe and often underdiagnosed form of secondary hypertension. Determining the aldosterone to renin ratio (ARR) in hypertensive patients has been shown to be a valuable screening test for identification of patients suffering from PA. Since the introduction of a more widespread ARR screening the number of PA patients significantly increased worldwide. Interpretation of ARR might be challenging: Several factors from posture to interfering drugs affect the ARR and need to be taken into account when collecting samples. In addition, the wide variety of available assay methods and lack of well-established cut-offs present a challenge to the clinician. This review discusses the usefulness and possible difficulties of ARR screening.

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