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Primary Aldosteronism

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106 Commerce Street, Suite 105 Lake Mary, FL 32746 TEL: 407.878.7606 • FAX: 407.878.7611 Order additional copies, at GuidelineCentral.com Copyright © 2016 All rights reserved ESALD16103 Disclaimer is Guideline attempts to define principles of practice that should produce high-quality patient care. It focuses on the needs of primary care practice, but also is applicable to providers at all levels. is Guideline should not be considered exclusive of other methods of care reasonably directed at obtaining the same results. e ultimate judgment concerning the propriety of any course of conduct must be made by the clinician aer consideration of each individual patient situation. Neither IGC, the medical associations, nor the authors endorse any product or service associated with the distributor of this clinical reference tool. Source Funder JW, Carey RM, Mantero F, Murad MH, Reincke M, Shibata H, Stowasser M, Young WF Jr. e Management of Primary Aldosteronism: Case Detection, Diagnosis, and Treatment: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2016 May;101(5):1889-916. Abbreviations ACE, angiotensin-converting enzyme; APA, aldosterone-producing adenoma; ARBs, angiotensin II type 1 receptor blockers; ARR, aldosterone-to-renin ratio; AVS, adrenal venous sampling ; BAH, bilateral adrenal hyperplasia; BP, blood pressure; CCT, captopril challenge test; CT, computed tomography; DHPs, dihydropyridines; DRC, direct renin concentration; ES, Endocrine Society; FH-I, -II, or -III, familial hyperaldosteronism type 1, 2, or 3; FN, false negative; FP, false positive; FST, fludrocortisone suppression test; FUT, furosemide upright test; GRA, glucocorticoid remediable aldosteronism; HRT, hormone replacement therapy; HT, hypertension; IAH, idiopathic adrenal hyperplasia; IHA, idiopathic hyperaldosteronism; K + , potassium; LV, leventricular; MR, mineralocorticoid receptor; MRA, MR agonist; MRI, magnetic resonance imaging ; NP-59, iodomethyl-19-norcholesterol; NSAIDs, nonsteroidal anti-inflammatory drugs; OC, oral contraceptives; 18-OHB, 18-hydroxycorticosterone; PA, primary aldosteronism; PAC, plasma aldosterone concentration; PHA-2, pseudohypoaldosteronism type 2 (familial hypertension and hyperkalemia with normal glomerular filtration rate); PRA, plasma renin activity; SIT, saline infusion test; UAH, unilateral adrenal hyperplasia Grading System Strength of Recommendation 1 = strong 2 = weak U = ungraded Quality of Evidence ⊕⊕⊕⊕ = high ⊕⊕⊕ = moderate ⊕⊕ = low ⊕ = very low

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