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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
