The usage of computed tomography and serum potassium in determining the subtypes of primary aldosteronism

Abstract

A article, entitled Significance of Computed Tomography and Serum Potassium in Predicting Subtype Diagnosis of Primary Aldosteronism published in JCEM in March, 2018, was translated into Chinese here after obtaining the copyright [Umakoshi H, Tsuiki M, Takeda Y, et al. J Clin Endocrinol Metab, 2018, 103(3): 900-908]. This is a multi-institutional retrospective cohort study and its aim was to develop an algorithm for adrenal venous sampling (AVS) based on subtype prediction by computed tomography (CT) and serum potassium. A total of 1 591 patients with primary aldosteronism (PA) were classified into four groups according to CT findings and potassium status. Subtype diagnosis of PA was determined by AVS. The prevalence and odds ratio for unilateral hyperaldosteronism on AVS were as follows: bilateral normal on CT with normokalemia, 6.2% (reference); unilateral disease on CT with normokalemia, 23.8% and OR=4.8 (95%CI 3.1-7.2); bilateral normal on CT with hypokalemia, 38.1% and OR=9.4 (95%CI 6.2-14.1), and unilateral disease on CT with hypokalemia, 70.6% and OR=36.4 (95%CI 24.7-53.5). Patients with PA with bilateral normal results on CT and normokalemia likely have a low prior probability of a lateralized form of AVS and could be treated medically, whereas those with unilateral disease on CT and hypokalemia have a high probability of a lateralized form of AVS. (Chin J Endocrinol Metab, 2018, 34: 522-526) Key words: Primary aldosteronism; Adrenal venous sampling; Hypokalemia