Adrenal Gland - Saline Suppression Test

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Clinical chemistry

Adrenal Gland

Saline suppression test

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

Revised: 22 September 2012, last major update - February 2010

Indication

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● To confirm the diagnosis of primary aldosteronism (J Clin Endocrinol Metab 2006;91:2618)

● Other tests recommended for screening or confirmation are captopril suppression test and fludrocortisone suppression (Horm Metab Res 2010 Jan 29 [Epub ahead of print])

Methodology

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● Infuse 2L of 0.9% saline over 4 hours ("saline infusion test") OR give oral NaCl tablets 10-12 gm daily for 3 days ("oral sodium loading test")

● Blood levels: plasma aldosterone greater than 5 ng/dl (140 pmol/L) confirms the diagnosis of primary hyperaldosteronism

● Urine levels: collect 24 hour urine for aldosterone, creatinine (to assess the adequacy of urine collection), and sodium (to ensure adequate intake) on the last day of sodium chloride administration; aldosterone levels > 10 μg/24 hours (28 nmol/24 hours) confirms the diagnosis

Clinical features

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● More difficult to perform than captopril suppression test, with comparable accuracy in patients with high sodium intake (Hypertension 2007;50:424)

End of Clinical chemistry > Adrenal Gland > Saline Suppression Test

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