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dc.creatorBaudrand, René
dc.creatorGuarda, Francisco J
dc.creatorTorrey, Jasmine
dc.creatorWilliams, Gordon
dc.creatorVaidya, Anand
dc.date.accessioned2021-08-23T22:59:55Z
dc.date.available2021-08-23T22:59:55Z
dc.date.issued2016
dc.identifier.urihttp://hdl.handle.net/10533/252739
dc.description.abstractContext: The aldosterone to renin ratio (ARR) is recommended to screen for primary aldosteronism (PA). Objective: To evaluate whether dietary sodium restriction results in misinterpretation of PA screening. Participants: Untreated hypertensives with ARR more than 20 on a high dietary sodium intake (HS) were also evaluated on a low dietary sodium intake (LS) (n = 241). Positive screening for PA was defined as: plasma renin activity (PRA) less than or equal to 1.0 ng/mL.h with serum aldosterone more than or equal to 6 ng/dL. PA was confirmed by a 24-hour urinary aldosterone excretion more than or equal to 12 mcg with urinary sodium more than 200 mmol. Results: Only 33% (79/241) of participants with an ARR more than 20 had a positive PA screen on HS. On LS, 56% (44/79) of these participants no longer met criteria for positive PA screening. When compared with participants with positive PA screening on both diets, participants with a positive screen on HS but negative on LS exhibited a significantly higher PRA on both diets. Remarkably, of the 48/79 participants who had PA confirmed, 52% had negative PA screening on LS. The distinguishing feature of these participants with "discordant" screening results was a larger rise in PRA on LS resulting in normalization of the ARR and higher Caucasian race prevalence. Conclusions: Sodium restriction is recommended in hypertension; however, it can significantly raise PRA, normalize the ARR, and result in false interpretation of PA screening. Milder phenotypes of PA, where PRA is not as suppressed, are most susceptible to dietary sodium influences on renin and ARR. Optimal screening for PA should occur under conditions of HS.
dc.language.isoeng
dc.relation.urihttps://doi.org/10.1210/jc.2016-1963
dc.rightsAtribución-NoComercial-SinDerivadas 3.0 Chile
dc.rightshttp://creativecommons.org/licenses/by-nc-nd/3.0/cl/
dc.titleDietary Sodium Restriction Increases the Risk of Misinterpreting Mild Cases of Primary Aldosteronism
dc.typeArticulo
dc.description.conicytinstrumentRegular 2015
dc.identifier.folio1150327
dc.description.conicytprogramFONDECYT
dc.relation.contesthandle/10533/111557
dc.rights.driverinfo:eu-repo/semantics/article
dc.rights.driverinfo:eu-repo/semantics/openAccess
dc.title.journalJOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
dc.relation.instrumenthandle/10533/111541
dc.relation.programhandle/10533/108045
dc.description.shortconicytprogramFONDECYT
dc.type.openaireinfo:eu-repo/semantics/publishedVersion


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