What are the indications of the diurnal rhythm of aldosterone 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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The circadian rhythm of aldosterone secretion in healthy individuals parallels that of cortisol and is corticotropin-dependent. The lowest values are observed around 11:30 pm to midnight, and the highest values occur early in the morning around 7:30-8:00 am (assuming a normal sleep-wake cycle). While this is preserved in patients with aldosteronomas, it is typically lost in patients with IAH.

Elevated levels of 18OH corticosterone and/or 18OH cortisol in plasma and urine may be found in some patients with aldosteronomas but are uncommon in IAH. [30, 31]

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