How is the oral salt loading test performed in the workup of hyperaldosteronism?

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

Patients should increase their sodium intake to more than 6 g/d for 3 days with diet and sodium chloride tabs. Potassium supplementation and daily potassium measurements are required for patients with hypokalemia. Patients perform 24-hour urine collection starting on day 3 for sodium and aldosterone. Potassium supplementation and daily potassium measurements are required for patients with hypokalemia. A 24-hour urinary aldosterone excretion of more than 12 mcg/d is consistent with PA, whereas 24-hour urinary sodium of 200 mEq/24 h indicates adequate intake. This test should not be performed in patients with uncontrolled hypertension, congestive heart failure, or arrhythmias. Renal insufficiency may confound the interpretation of the results (false negative).


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