Description

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

 

Criteria:

(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.


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