What is your preferred method for confirming the diagnosis of primary aldosteronism in a patient with an elevated plasma aldosterone to renin ratio?

The endocrine guidelines on primary aldo diagnosis (1) allow for 3 confirmatory tests: 24-hour urine, fludrocortisone suppression testing, and response to saline infusion. At UAB, we use the 24-hour urine collection. Most of our patients do not need additional salt loading during the 24-hour collect...

We usually do not proceed with "confirmatory" testing for primary aldosteronism if there is a high probability of primary aldosteronism, especially lateralizing (suppressed renin and aldosterone >10 ng/dl). We use aldosterone suppressive tests in case of indeterminate results in order to get more in...

We do an oral salt suppression test. This is the protocol that we use. Hope it helps.

Day 1- Take sodium chloride tablets 2 g 3 times a day. Also, take a potassium chloride tablet 40 mEq twice a day. Continue to monitor BP daily.

Day 2- Take sodium chloride tablets 2 g 3 times a day. Take a potassiu...