Screening Tests For Primary Aldosteronism

Types Relative frequency, %

Solitary adrenal adenoma 65

Bilateral adrenal hyperplasia 30

Unilateral adrenal hyperplasia 2

Glucocorticoid-remediable aldosteronism <1

Bilateral solitary adrenal adenomas <1

Adrenal carcinoma <1

Test Sensitivity, % Specificity, %

Serum potassium <3.5 mEq/L 75 ~20

Plasma renin activity <4 ng/mL/90 min >99 40-60

Urinary aldosterone >20 pg/d 70 60

Plasma aldosterone >15 ng/dL 90 60

Plasma aldosterone-plasma renin 99.8 98 activity ratio >15

Plasma aldosterone-plasma renin 96 100 activity ratio >30

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