How is a diagnosis of primary hyperaldosteronism confirmed?

Updated: Oct 19, 2018
  • Author: George P Chrousos, MD, FAAP, MACP, MACE, FRCP(London); Chief Editor: Robert P Hoffman, MD  more...
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Answer

Currently, US and Japanese guidelines recommend confirmatory testing in the work-up of PA; however, no test is seen as the criterion standard because of insufficient evidence.

The saline infusion test can confirm autonomous aldosterone secretion. Other tests described include measurement of urine aldosterone excretion during oral salt loading and the fludrocortisone suppression test. All tests rely on the principle that a lack of suppression of aldosterone excretion with intravascular expansion is indicative of aldosterone production.


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