The management of primary aldosteronism: case detection, diagnosis, and treatment: an endocrine society clinical practice guideline

• Tatyana Yu. Demidova
• Kishkovich Yu.S.
• Susareva O.V.

Abstract

For high-risk groups of hypertensive patients and those with hypokalemia, we recommend case detec­tion of primary aldosteronism by determining the aldosterone-renin ratio under standard conditions, and that a commonly used confirmatory test should confirm/exclude the condition. We recommend that all patients with primary aldosteronism undergo adrenal computed tomography as the initial study in subtype testing and to exclude adrenocortical carcinoma. We recommend that an experienced radiologist should establish/exclude unilateral primary aldosteronism using bilateral adrenal venous sampling, and if confirmed, should optimally be treated by laparoscopic adrenalectomy. We recommend that patients with bilateral adrenal hyperplasia or those unsuitable for surgery should be treated primarily with a mineralocorticoid receptor antagonist.

Keywords:primary aldosteronism, arterial hypertension, aldosterone-producing adenoma, aldosterone-renin ratio

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