Kocjan et al reported a clinical decision rule to identify a patient with primary aldosteronism who probably has bilateral adrenal disease. This can reduce the need for adrenal venous sampling. The authors are from University Medical Center Ljubljana and University of Primorska in Slovenia.

Patient selection: primary aldosteronism


Goal: to identify bilateral adrenal disease, avoiding the need for adrenal venous sampling



(1) serum potassium >= 3.5 mmol/L

(2) post-SIT (saline infusion test) aldosterone < 18 ng/dL

(3) either no or bilateral tumor found on CT (NOT unilateral mass)


Performance: 100% positive predictive value


If positive then the patient can be started immediately on medical treatment.

To read more or access our algorithms and calculators, please log in or register.