Fludrocortisone suppression test
Author: Renu Virk, M.D. (see Authors page)
Copyright: (c) 2002-2012, PathologyOutlines.com, Inc.
● Confirms the diagnosis of primary (hyper) aldosteronism
● Fludrocortisone suppresses aldosterone production in normal subjects (molecule is structurally similar to cortisone, Wikipedia), but not in patients with primary aldosteronism
● 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
● Levels should be < 10 g/d (28 nmol/d) in normal subjects
● Normal suppression excludes primary hyperaldosteronism
● 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)
End of Clinical Chemistry > Adrenal Gland > Fludrocortisone suppression test
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