Is adrenal venous sampling always necessary to differentiate between unilateral and bilateral primary aldosteronism? Lesson from the SPAIN-ALDO register.

Parra Ramírez P; Martín Rojas-Marcos P; Paja Fano M; González Boillos M; Peris BP; Pascual-Corrales E; García Cano AM; Ruiz-Sanchez JG; Vicente Delgado A; Gómez Hoyos E; Ferreira R; García Sanz I; Recasens Sala M; Barahona San Millan R; Picón César MJ; Díaz Guardiola P; Perdomo CM; Manjón-Miguélez L; García Centeno R; Percovich JC; Rebollo Román Á; Gracia Gimeno P; Robles Lázaro C; Morales-Ruiz M; Calatayud M; Furio Collao SA; Meneses D; Sampedro Nuñez MA; Escudero Quesada V; Mena Ribas E; Sanmartín Sánchez A; Gonzalvo Diaz C; Lamas C; Guerrero-Vázquez R; Del Castillo Tous M; Serrano Gotarredona J; Michalopoulou Alevras T; Moya Mateo EM; Hanzu FA; Araujo-Castro M

Is adrenal venous sampling always necessary to differentiate between unilateral and bilateral primary aldosteronism? Lesson from the SPAIN-ALDO register.

PURPOSE: To evaluate whether the clinical, biochemical and radiological features of patients with primary aldosteronism (PA) can predict both main subtypes of PA. METHODS: A retrospective multicenter study of PA patients followed in 27 Spanish tertiary hospitals (SPAIN-ALDO Register). Only patients...

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Autores:	Parra Ramírez P, Martín Rojas-Marcos P, Paja Fano M, González Boillos M, Peris BP, Pascual-Corrales E, García Cano AM, Ruiz-Sanchez JG, Vicente Delgado A, Gómez Hoyos E, Ferreira R, García Sanz I, Recasens Sala M, Barahona San Millan R, Picón César MJ, Díaz Guardiola P, Perdomo CM, Manjón-Miguélez L, García Centeno R, Percovich JC, Rebollo Román Á, Gracia Gimeno P, Robles Lázaro C, Morales-Ruiz M, Calatayud M, Furio Collao SA, Meneses D, Sampedro Nuñez MA, Escudero Quesada V, Mena Ribas E, Sanmartín Sánchez A, Gonzalvo Diaz C, Lamas C, Guerrero-Vázquez R, Del Castillo Tous M, Serrano Gotarredona J, Michalopoulou Alevras T, Moya Mateo EM, Hanzu FA, Araujo-Castro M
Tipo de recurso:	artículo
Estado:	Versión publicada
Fecha de publicación:	2023
País:	España
Institución:	Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
Repositorio:	r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
OAI Identifier:	oai:isabial.fundanetsuite.com:p9970
Acceso en línea:	https://isabial.portalinvestigacion.com/publicaciones9970 https://link.springer.com/article/10.1007/s12020-023-03609-y
Access Level:	acceso abierto
Palabra clave:	Adrenal venous sampling Cerebrovascular disease Dyslipidemia Primary aldosteronism Sleep apnea syndrome Sub-typing

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spelling	Is adrenal venous sampling always necessary to differentiate between unilateral and bilateral primary aldosteronism? Lesson from the SPAIN-ALDO register.Parra Ramírez PMartín Rojas-Marcos PPaja Fano MGonzález Boillos MPeris BPPascual-Corrales EGarcía Cano AMRuiz-Sanchez JGVicente Delgado AGómez Hoyos EFerreira RGarcía Sanz IRecasens Sala MBarahona San Millan RPicón César MJDíaz Guardiola PPerdomo CMManjón-Miguélez LGarcía Centeno RPercovich JCRebollo Román ÁGracia Gimeno PRobles Lázaro CMorales-Ruiz MCalatayud MFurio Collao SAMeneses DSampedro Nuñez MAEscudero Quesada VMena Ribas ESanmartín Sánchez AGonzalvo Diaz CLamas CGuerrero-Vázquez RDel Castillo Tous MSerrano Gotarredona JMichalopoulou Alevras TMoya Mateo EMHanzu FAAraujo-Castro MAdrenal venous samplingCerebrovascular diseaseDyslipidemiaPrimary aldosteronismSleep apnea syndromeSub-typingPURPOSE: To evaluate whether the clinical, biochemical and radiological features of patients with primary aldosteronism (PA) can predict both main subtypes of PA. METHODS: A retrospective multicenter study of PA patients followed in 27 Spanish tertiary hospitals (SPAIN-ALDO Register). Only patients with confirmed unilateral or bilateral PA based on adrenal venous sampling (AVS) and/or postsurgical biochemical cure after adrenalectomy were included. Supervised regression techniques were used for model development. RESULTS: 328 patients [270 unilateral PA (UPA), 58 bilateral PA (BPA)] were included. The area under the curve (AUC) for aldosterone/potassium ratio and aldosterone responses following saline infusion test were 0.602 [95%CI 0.520 to 0.684] and 0.574 [95% CI 0.446-0.701], respectively, to differentiate UPA from BPA. The AUC was 0.825 [95% 0.764-0.886] when the prediction model with seven parameters - comorbidities (dyslipidemia, cerebrovascular disease, sleep apnea syndrome [SAS]), systolic blood pressure (SBP), plasma aldosterone levels (PAC), hypokalemia and unilateral adrenal nodule >1 cm and normal contralateral adrenal gland on CT/MRI - was used. In patients without comorbidities, hypokalemia, SBP > 160 mmHg, PAC > 40 ng/dL, and unilateral adrenal lesions were associated with a likelihood of having a UPA of 98.5%. The chance of BPA was higher in individuals with comorbidities, SBP < 140 mmHg, normokalemia, low PAC levels, and no adrenal tumors on the CT/MRI (91.5%). CONCLUSION: A combination of high PAC, SBP > 160 mmHg, low serum potassium, a unilateral adrenal nodule>1 cm and no comorbidities could predict a UPA with a 98.5% accuracy.SPRINGER2023info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://isabial.portalinvestigacion.com/publicaciones9970https://link.springer.com/article/10.1007/s12020-023-03609-yENDOCRINEISSN: 1355008XISSNe: 15590100reponame:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicanteinstname:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)Inglésinfo:eu-repo/semantics/openAccessoai:isabial.fundanetsuite.com:p99702026-06-12T10:20:37Z
dc.title.none.fl_str_mv	Is adrenal venous sampling always necessary to differentiate between unilateral and bilateral primary aldosteronism? Lesson from the SPAIN-ALDO register.
title	Is adrenal venous sampling always necessary to differentiate between unilateral and bilateral primary aldosteronism? Lesson from the SPAIN-ALDO register.
spellingShingle	Is adrenal venous sampling always necessary to differentiate between unilateral and bilateral primary aldosteronism? Lesson from the SPAIN-ALDO register. Parra Ramírez P Adrenal venous sampling Cerebrovascular disease Dyslipidemia Primary aldosteronism Sleep apnea syndrome Sub-typing
title_short	Is adrenal venous sampling always necessary to differentiate between unilateral and bilateral primary aldosteronism? Lesson from the SPAIN-ALDO register.
title_full	Is adrenal venous sampling always necessary to differentiate between unilateral and bilateral primary aldosteronism? Lesson from the SPAIN-ALDO register.
title_fullStr	Is adrenal venous sampling always necessary to differentiate between unilateral and bilateral primary aldosteronism? Lesson from the SPAIN-ALDO register.
title_full_unstemmed	Is adrenal venous sampling always necessary to differentiate between unilateral and bilateral primary aldosteronism? Lesson from the SPAIN-ALDO register.
title_sort	Is adrenal venous sampling always necessary to differentiate between unilateral and bilateral primary aldosteronism? Lesson from the SPAIN-ALDO register.
dc.creator.none.fl_str_mv	Parra Ramírez P Martín Rojas-Marcos P Paja Fano M González Boillos M Peris BP Pascual-Corrales E García Cano AM Ruiz-Sanchez JG Vicente Delgado A Gómez Hoyos E Ferreira R García Sanz I Recasens Sala M Barahona San Millan R Picón César MJ Díaz Guardiola P Perdomo CM Manjón-Miguélez L García Centeno R Percovich JC Rebollo Román Á Gracia Gimeno P Robles Lázaro C Morales-Ruiz M Calatayud M Furio Collao SA Meneses D Sampedro Nuñez MA Escudero Quesada V Mena Ribas E Sanmartín Sánchez A Gonzalvo Diaz C Lamas C Guerrero-Vázquez R Del Castillo Tous M Serrano Gotarredona J Michalopoulou Alevras T Moya Mateo EM Hanzu FA Araujo-Castro M
author	Parra Ramírez P
author_facet	Parra Ramírez P Martín Rojas-Marcos P Paja Fano M González Boillos M Peris BP Pascual-Corrales E García Cano AM Ruiz-Sanchez JG Vicente Delgado A Gómez Hoyos E Ferreira R García Sanz I Recasens Sala M Barahona San Millan R Picón César MJ Díaz Guardiola P Perdomo CM Manjón-Miguélez L García Centeno R Percovich JC Rebollo Román Á Gracia Gimeno P Robles Lázaro C Morales-Ruiz M Calatayud M Furio Collao SA Meneses D Sampedro Nuñez MA Escudero Quesada V Mena Ribas E Sanmartín Sánchez A Gonzalvo Diaz C Lamas C Guerrero-Vázquez R Del Castillo Tous M Serrano Gotarredona J Michalopoulou Alevras T Moya Mateo EM Hanzu FA Araujo-Castro M
author_role	author
author2	Martín Rojas-Marcos P Paja Fano M González Boillos M Peris BP Pascual-Corrales E García Cano AM Ruiz-Sanchez JG Vicente Delgado A Gómez Hoyos E Ferreira R García Sanz I Recasens Sala M Barahona San Millan R Picón César MJ Díaz Guardiola P Perdomo CM Manjón-Miguélez L García Centeno R Percovich JC Rebollo Román Á Gracia Gimeno P Robles Lázaro C Morales-Ruiz M Calatayud M Furio Collao SA Meneses D Sampedro Nuñez MA Escudero Quesada V Mena Ribas E Sanmartín Sánchez A Gonzalvo Diaz C Lamas C Guerrero-Vázquez R Del Castillo Tous M Serrano Gotarredona J Michalopoulou Alevras T Moya Mateo EM Hanzu FA Araujo-Castro M
author2_role	author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author
dc.subject.none.fl_str_mv	Adrenal venous sampling Cerebrovascular disease Dyslipidemia Primary aldosteronism Sleep apnea syndrome Sub-typing
topic	Adrenal venous sampling Cerebrovascular disease Dyslipidemia Primary aldosteronism Sleep apnea syndrome Sub-typing
description	PURPOSE: To evaluate whether the clinical, biochemical and radiological features of patients with primary aldosteronism (PA) can predict both main subtypes of PA. METHODS: A retrospective multicenter study of PA patients followed in 27 Spanish tertiary hospitals (SPAIN-ALDO Register). Only patients with confirmed unilateral or bilateral PA based on adrenal venous sampling (AVS) and/or postsurgical biochemical cure after adrenalectomy were included. Supervised regression techniques were used for model development. RESULTS: 328 patients [270 unilateral PA (UPA), 58 bilateral PA (BPA)] were included. The area under the curve (AUC) for aldosterone/potassium ratio and aldosterone responses following saline infusion test were 0.602 [95%CI 0.520 to 0.684] and 0.574 [95% CI 0.446-0.701], respectively, to differentiate UPA from BPA. The AUC was 0.825 [95% 0.764-0.886] when the prediction model with seven parameters - comorbidities (dyslipidemia, cerebrovascular disease, sleep apnea syndrome [SAS]), systolic blood pressure (SBP), plasma aldosterone levels (PAC), hypokalemia and unilateral adrenal nodule >1 cm and normal contralateral adrenal gland on CT/MRI - was used. In patients without comorbidities, hypokalemia, SBP > 160 mmHg, PAC > 40 ng/dL, and unilateral adrenal lesions were associated with a likelihood of having a UPA of 98.5%. The chance of BPA was higher in individuals with comorbidities, SBP < 140 mmHg, normokalemia, low PAC levels, and no adrenal tumors on the CT/MRI (91.5%). CONCLUSION: A combination of high PAC, SBP > 160 mmHg, low serum potassium, a unilateral adrenal nodule>1 cm and no comorbidities could predict a UPA with a 98.5% accuracy.
publishDate	2023
dc.date.none.fl_str_mv	2023
dc.type.none.fl_str_mv	info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion
format	article
status_str	publishedVersion
dc.identifier.none.fl_str_mv	https://isabial.portalinvestigacion.com/publicaciones9970 https://link.springer.com/article/10.1007/s12020-023-03609-y
url	https://isabial.portalinvestigacion.com/publicaciones9970 https://link.springer.com/article/10.1007/s12020-023-03609-y
dc.language.none.fl_str_mv	Inglés
language_invalid_str_mv	Inglés
dc.rights.none.fl_str_mv	info:eu-repo/semantics/openAccess
eu_rights_str_mv	openAccess
dc.publisher.none.fl_str_mv	SPRINGER
publisher.none.fl_str_mv	SPRINGER
dc.source.none.fl_str_mv	ENDOCRINE ISSN: 1355008X ISSNe: 15590100 reponame:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante instname:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
instname_str	Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
reponame_str	r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
collection	r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
repository.name.fl_str_mv
repository.mail.fl_str_mv
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Is adrenal venous sampling always necessary to differentiate between unilateral and bilateral primary aldosteronism? Lesson from the SPAIN-ALDO register.

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