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Statements

Subject Item
n2:RIV%2F00179906%3A_____%2F12%3A10125031%21RIV13-MZ0-00179906
rdf:type
n6:Vysledek skos:Concept
rdfs:seeAlso
http://dx.doi.org/10.1530/EJE-11-0914
dcterms:description
Objective: Confirmatory testing of suspected primary aldosteronism (PA) requires an extensive medication switch that can be difficult for patients with severe complicated hypertension and/or refractory hypokalemia. For this reason, we investigated the effect of chronic antihypertensive medication on confirmatory testing results. To allow the results to be interpreted, the reproducibility of confirmatory testing was also evaluated. Design and methods: The study enrolled 114 individuals with suspected PA who underwent two confirmatory tests. The patients were divided into two groups. In Group A, both tests were performed on the guidelines-recommended therapy, i.e. not interfering with the renin-angiotensin-aldosterone system. In Group B, the first test was performed on chronic therapy with the exclusion of thiazides, loop diuretics, and aldosterone antagonists; and the second test was performed on guidelines-recommended therapy. Saline infusion, preceded by oral sodium loading, was used to suppress aldosterone secretion. Results: Agreement in the interpretation of the two confirmatory tests was observed in 84 and 66% of patients in Groups A and B respectively. For all 20 individuals in Group A who ever had end-test serum aldosterone levels R240 pmol/l, aldosterone was concordantly nonsuppressible during the other test. Similarly, for all 16 individuals in Group B who had end-test serum aldosterone levels R240 pmol/l on modified chronic therapy, aldosterone remained nonsuppressible with guidelines-recommended therapy. Conclusion: Confirmatory testing performed while the patient is on chronic therapy without diuretics and aldosterone antagonists can confirm the diagnosis of PA, provided serum aldosterone remains markedly elevated at the end of saline infusion. Objective: Confirmatory testing of suspected primary aldosteronism (PA) requires an extensive medication switch that can be difficult for patients with severe complicated hypertension and/or refractory hypokalemia. For this reason, we investigated the effect of chronic antihypertensive medication on confirmatory testing results. To allow the results to be interpreted, the reproducibility of confirmatory testing was also evaluated. Design and methods: The study enrolled 114 individuals with suspected PA who underwent two confirmatory tests. The patients were divided into two groups. In Group A, both tests were performed on the guidelines-recommended therapy, i.e. not interfering with the renin-angiotensin-aldosterone system. In Group B, the first test was performed on chronic therapy with the exclusion of thiazides, loop diuretics, and aldosterone antagonists; and the second test was performed on guidelines-recommended therapy. Saline infusion, preceded by oral sodium loading, was used to suppress aldosterone secretion. Results: Agreement in the interpretation of the two confirmatory tests was observed in 84 and 66% of patients in Groups A and B respectively. For all 20 individuals in Group A who ever had end-test serum aldosterone levels R240 pmol/l, aldosterone was concordantly nonsuppressible during the other test. Similarly, for all 16 individuals in Group B who had end-test serum aldosterone levels R240 pmol/l on modified chronic therapy, aldosterone remained nonsuppressible with guidelines-recommended therapy. Conclusion: Confirmatory testing performed while the patient is on chronic therapy without diuretics and aldosterone antagonists can confirm the diagnosis of PA, provided serum aldosterone remains markedly elevated at the end of saline infusion.
dcterms:title
Confirmatory testing in primary aldosteronism: extensive medication switching is not needed in all patients Confirmatory testing in primary aldosteronism: extensive medication switching is not needed in all patients
skos:prefLabel
Confirmatory testing in primary aldosteronism: extensive medication switching is not needed in all patients Confirmatory testing in primary aldosteronism: extensive medication switching is not needed in all patients
skos:notation
RIV/00179906:_____/12:10125031!RIV13-MZ0-00179906
n6:predkladatel
n7:ico%3A00179906
n3:aktivita
n13:Z n13:I
n3:aktivity
I, Z(MSM0021620817)
n3:cisloPeriodika
4
n3:dodaniDat
n10:2013
n3:domaciTvurceVysledku
n11:4472136 n11:6971849 n11:8737452 n11:7414854 n11:3677958
n3:druhVysledku
n18:J
n3:duvernostUdaju
n15:S
n3:entitaPredkladatele
n12:predkladatel
n3:idSjednocenehoVysledku
128446
n3:idVysledku
RIV/00179906:_____/12:10125031
n3:jazykVysledku
n4:eng
n3:klicovaSlova
diagnosis; saline infusion test
n3:klicoveSlovo
n19:diagnosis n19:saline%20infusion%20test
n3:kodStatuVydavatele
GB - Spojené království Velké Británie a Severního Irska
n3:kontrolniKodProRIV
[C38B3055E7C1]
n3:nazevZdroje
European Journal of Endocrinology
n3:obor
n16:FB
n3:pocetDomacichTvurcuVysledku
5
n3:pocetTvurcuVysledku
5
n3:rokUplatneniVysledku
n10:2012
n3:svazekPeriodika
166
n3:tvurceVysledku
Pelouch, Radek Ceral, Jiří Malířová, Eva Ballon, Marek Solař, Miroslav
n3:wos
000302343500014
n3:zamer
n14:MSM0021620817
s:issn
0804-4643
s:numberOfPages
8
n17:doi
10.1530/EJE-11-0914