ABSTRACT
Objective: To evaluate the diagnostic value of saline infusion test (SIT) in patients with primary aldosteronism (PHA). Methods: A total of 116 patients with PHA or essential hypertension (EH) treated in our hospital from 1994-06 to 2013-05 were retrospectively studied. The patients were divided into 2 groups: PHA group,n=72 and EH group, the patients with excluded PHA,n=44. post-SIT plasma levels of aldosterone and post-SIT ratio of aldosterone/renin activity were evaluated by ROC curve in order to analyze the diagnostic capability and the best diagnostic cut-off point. Results: The area under curve (AUC) by ROC for post-SIT aldosterone level was 0.759, the sensitivity and speciifcity were 74.6% and 63.6% respectively; AUC for post-SIT ratio of aldosterone/renin activity was 0.899, the sensitivity and speciifcity were 83.6% and 88.6% with the best diagnostic cut-off point at 111 [ng/dl:ng/(ml?h)]. Conclusion: Post-SIT plasma level of aldosterone and post-SIT ratio of aldosterone/renin activity had the diagnostic value of PHA; post-SIT ratio of aldosterone/renin activity had the higher diagnostic value of PHA.
ABSTRACT
Objective To confirm the most effectively screening conditions by comparing the ARR values of different posi‐tions after saline load test .Methods After exclusion the other secondary hypertension ,the completion of saline dressing test ,84 ca‐ses diagnosed hypertensive patients under saline load test results were divided into primary aldosteronism group (pH ,52 cases) and primary hypertension group (32 cases) .Analyzed plasma aldosterone (PAC) ,renin (PRA) values of upright and decumbent body positions ,their ARR values were calculated and the urine aldosterone was tested .Results Those whose upright position ARR rati‐os higher than 240(pg/mL)/(ng · mL -1 · h-1 ) were accounted for 80 .77% (42/52) and 43 .75% (14/32) ,respectively in the both PA group and PH group;Those whose upright position ARR ratios higher than 240(pg/mL)/(ng · mL -1 · h-1 ) and decumbent position PAC higher than 150 pg/mL were accounted for 65 .39% (34/52) and 3 .13% (1/32) ,respectively in the both PA group and ph group;The specificity of this method for PA was 96 .88% .Those whose upright position ARR ratios higher than 240(pg/mL)/(ng · mL -1 · h-1 ) and decumbent position PAC higher than 150 pg/mL and urine aldosterone higher than 10 μg/24 h ,The specificity of this method for PA was 100 .00% .Conclusion It is an effective screening method for primary aldosteronism when ARR values of upright position higher than 240(pg/mL)/(ng · mL -1 · h-1 ) ,PAC of decumbent position higher than 150 pg/mL and urine aldosterone higher than 10 μg/24 h .