A short review of primary aldosteronism in a question and answer fashion

Objectives. The aim of this study was to present up to date information concerning the diagnosis and treatment of primary aldosteronism (PA). PA is the most common cause of endocrine hypertension. It has been reported up to 24% of selective referred hypertensive patients. Methods. We did a search in...

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Autores principales:	Farrugia Frederick-Anthony, Zavras Nicolaos, Martikos Georgios, Tzanetis Panagiotis, Charalampopoulos Anestis, Misiakos Evangelos P., Sotiropoulos Dimitrios, Koliakos Nikolaos
Formato:	article
Lenguaje:	EN
Publicado:	Sciendo 2018
Materias:	primary aldosteronism aldosterone producing adenoma idiopathic adrenal hyperplasia diagnosis radiology treatment surgery Diseases of the endocrine glands. Clinical endocrinology RC648-665
Acceso en línea:	https://doaj.org/article/72038cff5ae84d06866918d16555abab
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spelling	oai:doaj.org-article:72038cff5ae84d06866918d16555abab2021-12-02T17:49:32ZA short review of primary aldosteronism in a question and answer fashion1336-032910.2478/enr-2018-0005https://doaj.org/article/72038cff5ae84d06866918d16555abab2018-01-01T00:00:00Zhttps://doi.org/10.2478/enr-2018-0005https://doaj.org/toc/1336-0329Objectives. The aim of this study was to present up to date information concerning the diagnosis and treatment of primary aldosteronism (PA). PA is the most common cause of endocrine hypertension. It has been reported up to 24% of selective referred hypertensive patients. Methods. We did a search in Pub-Med and Google Scholar using the terms: PA, hyperaldosteronism, idiopathic adrenal hyperplasia, diagnosis of PA, mineralocorticoid receptor antagonists, adrenalectomy, and surgery. We also did cross-referencing search with the above terms. We had divided our study into five sections: Introduction, Diagnosis, Genetics, Treatment, and Conclusions. We present our results in a question and answer fashion in order to make reading more interesting. Results. PA should be searched in all high-risk populations. The gold standard for diagnosis PA is the plasma aldosterone/plasma renin ratio (ARR). If this test is positive, then we proceed with one of the four confirmatory tests. If positive, then we proceed with a localizing technique like adrenal vein sampling (AVS) and CT scan. If the lesion is unilateral, after proper preoperative preparation, we proceed, in adrenalectomy. If the lesion is bilateral or the patient refuses or is not fit for surgery, we treat them with mineralocorticoid receptor antagonists, usually spironolactone. Conclusions. Primary aldosteronism is the most common and a treatable case of secondary hypertension. Only patients with unilateral adrenal diseases are eligible for surgery, while patients with bilateral and non-surgically correctable PA are usually treated by mineralocorticoid receptor antagonist (MRA). Thus, the distinction between unilateral and bilateral aldosterone hypersecretion is crucial.Farrugia Frederick-AnthonyZavras NicolaosMartikos GeorgiosTzanetis PanagiotisCharalampopoulos AnestisMisiakos Evangelos P.Sotiropoulos DimitriosKoliakos NikolaosSciendoarticleprimary aldosteronismaldosterone producing adenomaidiopathic adrenal hyperplasiadiagnosisradiologytreatmentsurgeryDiseases of the endocrine glands. Clinical endocrinologyRC648-665ENEndocrine Regulations, Vol 52, Iss 1, Pp 27-40 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	primary aldosteronism aldosterone producing adenoma idiopathic adrenal hyperplasia diagnosis radiology treatment surgery Diseases of the endocrine glands. Clinical endocrinology RC648-665
spellingShingle	primary aldosteronism aldosterone producing adenoma idiopathic adrenal hyperplasia diagnosis radiology treatment surgery Diseases of the endocrine glands. Clinical endocrinology RC648-665 Farrugia Frederick-Anthony Zavras Nicolaos Martikos Georgios Tzanetis Panagiotis Charalampopoulos Anestis Misiakos Evangelos P. Sotiropoulos Dimitrios Koliakos Nikolaos A short review of primary aldosteronism in a question and answer fashion
description	Objectives. The aim of this study was to present up to date information concerning the diagnosis and treatment of primary aldosteronism (PA). PA is the most common cause of endocrine hypertension. It has been reported up to 24% of selective referred hypertensive patients. Methods. We did a search in Pub-Med and Google Scholar using the terms: PA, hyperaldosteronism, idiopathic adrenal hyperplasia, diagnosis of PA, mineralocorticoid receptor antagonists, adrenalectomy, and surgery. We also did cross-referencing search with the above terms. We had divided our study into five sections: Introduction, Diagnosis, Genetics, Treatment, and Conclusions. We present our results in a question and answer fashion in order to make reading more interesting. Results. PA should be searched in all high-risk populations. The gold standard for diagnosis PA is the plasma aldosterone/plasma renin ratio (ARR). If this test is positive, then we proceed with one of the four confirmatory tests. If positive, then we proceed with a localizing technique like adrenal vein sampling (AVS) and CT scan. If the lesion is unilateral, after proper preoperative preparation, we proceed, in adrenalectomy. If the lesion is bilateral or the patient refuses or is not fit for surgery, we treat them with mineralocorticoid receptor antagonists, usually spironolactone. Conclusions. Primary aldosteronism is the most common and a treatable case of secondary hypertension. Only patients with unilateral adrenal diseases are eligible for surgery, while patients with bilateral and non-surgically correctable PA are usually treated by mineralocorticoid receptor antagonist (MRA). Thus, the distinction between unilateral and bilateral aldosterone hypersecretion is crucial.
format	article
author	Farrugia Frederick-Anthony Zavras Nicolaos Martikos Georgios Tzanetis Panagiotis Charalampopoulos Anestis Misiakos Evangelos P. Sotiropoulos Dimitrios Koliakos Nikolaos
author_facet	Farrugia Frederick-Anthony Zavras Nicolaos Martikos Georgios Tzanetis Panagiotis Charalampopoulos Anestis Misiakos Evangelos P. Sotiropoulos Dimitrios Koliakos Nikolaos
author_sort	Farrugia Frederick-Anthony
title	A short review of primary aldosteronism in a question and answer fashion
title_short	A short review of primary aldosteronism in a question and answer fashion
title_full	A short review of primary aldosteronism in a question and answer fashion
title_fullStr	A short review of primary aldosteronism in a question and answer fashion
title_full_unstemmed	A short review of primary aldosteronism in a question and answer fashion
title_sort	short review of primary aldosteronism in a question and answer fashion
publisher	Sciendo
publishDate	2018
url	https://doaj.org/article/72038cff5ae84d06866918d16555abab
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A short review of primary aldosteronism in a question and answer fashion

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