Home   Chapter Home   Jobs   Conferences   Fellowships   Books

 

 

Advertisement

 

Clinical chemistry

Adrenal Gland

Fludrocortisone suppression test

 

Author: Renu Virk, M.D. (see Authors page)

Revised: 21 September 2012, last major update - February 2010

Copyright: (c) 2002-2012, PathologyOutlines.com, Inc.

 

Indication

=========================================================================

● Confirms the diagnosis of primary (hyper) aldosteronism

● One of four tests recommended for screening or confirmation: also oral sodium loading, saline infusion and captopril suppression (Horm Metab Res 2010 Jan 29 [Epub ahead of print])

 

Rationale

=========================================================================

● Fludrocortisone suppresses aldosterone production in normal subjects (molecule is structurally similar to cortisone, Wikipedia), but not in patients with primary aldosteronism

 

Procedure

=========================================================================

● Correct hypokalemia if patient is hypokalemic before administering this test

● Give fludrocortisone 0.2 mg twice daily with 500 mg NaCl supplementation for 3 days (Scand J Clin Lab Invest 2009;69:234)

● Measure urine aldosterone excretion on the third day

 

Normal reference

=========================================================================

● Levels should be < 10 g/d (28 nmol/d) in normal subjects

● Normal suppression excludes primary hyperaldosteronism

 

Adverse effects

=========================================================================

● May precipitate severe hypokalemia

● Serum potassium should be monitored regularly during the test

● Due to sodium loading, this test should not be used in the elderly and in patients with severe hypertension

● Test should be used with care and is not a first line screening test

 

Clinical - other

=========================================================================

● Intravenous saline load test is a reasonably good alternative to this more expensive and complex test to diagnose primary aldosteronism after a positive screening test (J Clin Endocrinol Metab 2006;91:2618)

 

Additional references

=========================================================================

Leeds General Infirmary & Harrogate General Hospital

 

End of Clinical Chemistry > Adrenal Gland > Fludrocortisone suppression test

 

 

This information is intended for physicians and related personnel, who understand that medical information is often imperfect, and must also be interpreted in the context of a patient's clinical data using reasonable medical judgment.  This website should not be used as a substitute for the advice of a licensed physician.

 

All information on this website is protected by copyright of PathologyOutlines.com, Inc.  Information from third parties may also be protected by copyright.  Please contact us at copyrightPathOut@gmail.com with any questions (click here for other contact information).