Laboratory Diagnostics of Primary Hyperaldosteronism and its Peculiarities (Literature Review).

The final stage of the diagnostic of primary hyperaldosteronism is to identify the causes of excessive secretion of aldosterone and determination of its variants. Based on the analysis of literature data, the diagnostic value, sensitivity and specificity of the methods of radiation diagnostics for primary hyperaldosteronism were assessed: ultrasound, computed tomography, magnetic resonance imaging, photon emission tomography, magnetic resonance spectroscopy, scintigraphy with iodine radiopharmaceuticals. The causes of false-positive and false-negative evaluations of changes in adrenal glands in the application of these diagnostics have been analyzed. There are many genetic and morphological studies when searching the literature data on the principles and methods of distinguishing the nosological forms of primary hyperaldosteronism based on the results of the aldosterone level estimation in the separated blood from the central veins of both adrenal glands or segmental veins of one gland with subsequent determination of the concentration gradient. It was noted that topical diagnostics and, especially, the determination of nosological forms of primary hyperaldosteronism are complex and expensive, but their results allow choosing an appropriate treatment approach for each particular case.

Topical Diagnosis and Determination of the Primary Hyperaldosteronism Variant.

Laboratory diagnosis of primary hyperaldosteronism is based on determining blood levels of aldosterone, renin on request, potassium, and sodium. The results of these studies are significantly influenced by drugs, preparation for the study and blood collection methods, age, gender, and concomitant diseases. The work analyzes the factors influencing the results of the study of aldosterone and identifies the main ways of their exclusion at each stage of the diagnosis. Their neglecting is the determining factor in obtaining false results, diagnostic errors, the selection of ill-treatment tactics, and inadequate treatment. All these diagnostic problems are covered in a variety of ways in the review, which is based on the analysis of results of individual authors' research and practical and clinical recommendations from leading world endocrinological associations. Results of laboratory diagnostics of PHA depend on the influence of many factors. Among them, it is essential to use different medication drugs, the rules for preparing for the study, and the method of conducting it. In assessing the results of research, it is necessary to take into account not only the indicators of the level of aldosterone in the blood but also the features of the clinical course of the disease, its compliance to the drug therapy, age, and gender of the patients.