What is the role of serum potassium and bicarbonate testing in the workup of primary aldosteronism?

Updated: Mar 24, 2020
  • Author: Gabriel I Uwaifo, MD; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Answer

Hypokalemia and metabolic alkalosis have low sensitivities and specificities for primary aldosteronism when these levels are tested by themselves. Hypokalemia (serum potassium level < 3.6 mEq/L) has a sensitivity of 75-80% while the patient is on a normal sodium diet. [5] Typically, it is associated with mild metabolic alkalosis (serum bicarbonate level >31 mEq/L) and inappropriate kaliuresis (urinary potassium excretion >30 mmol/day).


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