Endocrine Abstracts

Objectives: Primary aldosteronism (PA) is considered to be the most common cause of secondary hypertension. Therefore, a relevance of early diagnosis of PA is obvious.

Methods: We evaluated 98 patients with hypertension in age 47.8±1.4 years. We measured serum potassium by indirect porentiometry, serum aldosterone and plasma rennin activity (PRA) by RIA, serum corticosterone (B), 18-hydroxycorticosterone (18-OH-B), 11-deoxycorticosterone (DOC), 11-dehydrocorticosterone (A), 11-deoxycortisol (S) and urine 18-hydroxycorticosterone (U18-OH-B) by high effective liquid chromatography (HELC). All patients underwent saline infusin test and computed tomography with contrast. Adrenal vein sampling (AVS) was performed in all patients with confirmed PA.

Results: PA was diagnosed in 46 patients, 27 of them had unilateral form – aldosterone-producing adenoma (APA), 19 – idiopathic hyperplasia (IHA). 52 patients were found essential hypertensives (EH), 27 of them were low-renin EH. PA patients had higher levels of some corticosteroids than EH: B (6.5±0.8 vs 3.0±0.6 ng/ml respectively, P<0.001), DOC (7.8±1.4 vs 2.0±1.8 ng/ml respectively, P<0.01), 18-OH-B (2.1±0.5 vs 4.8±0.5 ng/ml respectively, P<0.001), S (4.4±1.2 vs 1.0±0.3 ng/ml respectively, P<0.01), A (6.4±0.8 vs 2.5±0.3 ng/ml respectively, P<0.001).

Conclusion: The determination of the precursors of aldosterone in blood and urine samples by HELC is a safe method for the patients who have contraindications to recommended confirmatory tests. It can be used in patients with uncontrolled hypertension and high risk of cardiovascular complications. Our data showed that increased levels of serum B, S, DOC, A and 18-OH-B, U18-OH-B are laboratory signs of PA which can be determined during screening.