Value of Plasma Aldosterone/Potassium Ratio in Predicting Primary Aldosteronism in Patients Scheduled for Confirmatory Testing
Endocrinology Research and Practice, cilt.29, sa.4, ss.333-337, 2025 (ESCI, Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 29 Sayı: 4
- Basım Tarihi: 2025
- Doi Numarası: 10.5152/erp.2025.25716
- Dergi Adı: Endocrinology Research and Practice
- Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.333-337
- Anahtar Kelimeler: Endocrine hypertension, potassium, primary aldosteronism, saline infusion test
- Sağlık Bilimleri Üniversitesi Adresli: Hayır
Özet
Objective: Primary aldosteronism (PA) is a common cause of endocrine hypertension, yet there are some difficulties in diagnosing the disease. The saline infusion test (SIT), a standard confirmatory test, has limitations such as contraindications, hospitalization, and high cost. This study evaluates the potential of the plasma aldosterone/potassium (A/K) ratio in predicting PA. Methods: The study included 118 patients who underwent SIT; 57 were diagnosed with PA based on positive SIT and/or captopril challenge test results, adrenal imaging, and multidisciplinary clinical judgment. Aldosterone, plasma renin activity, and potassium and aldosterone-to-renin ratio (ARR) levels at admission, as well as SIT results and imaging findings, were retrospectively reviewed and compared between patients with and without PA. Results: Patients with PA had higher aldosterone levels (P <.001) and ARR (P <.001) but lower potassium levels (P <.001) and PRA (P =.01). The A/K ratio was significantly higher in the PA group (P <.001). Receiver operating characteristic analysis showed that an A/K ratio cut-off of 5.4 could distin-guish PA patients from non-PA patients [AUC (95% CI) = 0.811 (0.733-0.890), P <.001], with 73.7% sensitivity and 77.0% specificity. Univariate and multivariate analyses indicated that a high A/K ratio increased the likelihood of a PA diagnosis, with an A/K ratio above 5.4 associated with a 4.585-fold higher risk (95% CI: 1.181-17.799, P =.028). Conclusion: The A/K ratio may predict PA. It offers advantages such as no need for potassium replace-ment or hospitalization, making it a useful supplementary parameter for diagnosing PA, particularly in patients for whom confirmatory tests are unsuitable.