原発性アルドステロン症の診断における経口食塩負荷試験の有用性(第3回副腎静脈サンプリング研究会プロシーディングス)

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  • ゲンパツセイ アルドステロンショウ ノ シンダン ニ オケル ケイコウ ショクエン フカ シケン ノ ユウヨウセイ
  • Oral Salt Loading in the Diagnosis of Primary Aldosteronism

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Accurate and rapid diagnosis of primary aldosteronism is crucial, since patients with this condition often have cerebrovascular and cardiovascular complications. In our hospital, we screen hypertensive patients with hypokalemia or adrenal tumors, and patients who are treatment-resistant to hypertensive agents. First, we identify patients with a high plasma aldosterone concentration, low renin, or high aldosterone-to-renin ratio (ARR). Then, before performing primary aldosteronism tests to localize a lesion, we perform an oral salt loading or upright posture furosemide test. We then compare these tests. Urine aldosterone excretion of more than 12μg/day under an oral salt loading (urine Na>170mmol/day) and post-furosemide active renin concentration at 120min of less than 3.3pg/ml are appropriate cutoff points to confirm primary aldosteronism.

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