Would you start a mineralocorticoid receptor antagonist in patients with unilateral primary aldosteronism while they are awaiting adrenalectomy?

It depends on their blood pressure and potassium levels. Some of our patients are already on MRA at the time of their diagnosis without a need to get off the medication. Others may be started or returned to MRA after completing their biochemical workup. We recommend stopping MRA on the day of surger...

I usually keep the MRA therapy ongoing, and stop it only 24-48 hours prior to the surgery in anticipation of GA/possible hyperkalemia. If there are "non-Conn’s” related indications (DKD/CHF), we are switching over to finerenenone.

Yes, I keep them on MRA Therapy.