How is the postural stimulation test used to determine primary aldosteronism subtype?

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

Aldosteronomas are associated with an anomalous decrease in the aldosterone level with upright posture, in contrast to patients with idiopathic adrenal hyperplasia (IAH), in whom a renin-angiotensin system (RAS)–mediated increase in aldosterone level occurs with upright posture.

Similarly, a serum aldosterone level surge occurs in patients with renin-responsive adenomas (RRAs), low-renin essential HTN, and very rare cases of unilateral adrenal hyperplasia (the latter presenting with features intermediate between idiopathic adrenal hyperplasia [IAH] and aldosterone-producing adrenal adenoma; occasionally designated as “intermediate aldosteronism”). [29]


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