A prediction model for primary aldosteronism when the salt loading test is inconclusive
| العنوان: | A prediction model for primary aldosteronism when the salt loading test is inconclusive |
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| المؤلفون: | van Herwaarden Ae, Marieke Velema, Linssen Ejm, Jaap Deinum, Groenewoud Hjmm, Timmers Hjlm, van der Wilt Gj, Hermus Armm, Lenders Jwm |
| المصدر: | Endocrine Connections Endocrine Connections, Vol 7, Iss 12, Pp 1308-1314 (2018) |
| سنة النشر: | 2018 |
| مصطلحات موضوعية: | medicine.medical_specialty, genetic structures, inconclusive salt loading test, Endocrinology, Diabetes and Metabolism, 030209 endocrinology & metabolism, Context (language use), 030204 cardiovascular system & hematology, Logistic regression, Plasma renin activity, lcsh:Diseases of the endocrine glands. Clinical endocrinology, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Endocrinology, Primary aldosteronism, Internal medicine, Positive predicative value, Internal Medicine, medicine, Salt loading, Aldosterone, lcsh:RC648-665, primary aldosteronism, business.industry, Research, logistic regression, Retrospective cohort study, medicine.disease, prediction model, chemistry, adrenal, business |
| الوصف: | Objective To develop a prediction model to confirm or exclude primary aldosteronism (PA) in patients with an inconclusive salt loading test (SLT). Context Diagnosis in patients with a suspicion of PA can be confirmed using an SLT. In case of inconclusive test results the decision about how to manage the patient is usually based on contextual clinical data. Design We included a retrospective cohort of 276 patients in the final analysis. Methods All patients underwent an SLT between 2005 and 2016 in our university medical center. The SLT was inconclusive (post-infusion aldosterone levels 140–280 pmol/L) in 115 patients. An expert panel then used contextual clinical data to diagnose PA in 45 of them. Together with 101 patients with a positive SLT this resulted in a total of 146 patients with PA. A total of 11 variables were used in a multivariable logistic regression analysis. We assessed internal validity by bootstrapping techniques. Results The following variables were independently associated with PA: more intense potassium supplementation, lower plasma potassium concentration, lower plasma renin concentration before SLT and higher plasma aldosterone concentration after SLT. The resulting prediction model had a sensitivity of 84.4% and a specificity of 94.3% in patients with an inconclusive SLT. The positive and negative predictive values were 90.5 and 90.4%, respectively. Conclusions We developed a prediction model for the diagnosis of PA in patients with an inconclusive SLT that results in a diagnosis that was in high agreement with that of an expert panel. |
| تدمد: | 2049-3614 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::d4efe5200b4ca8112ac6ea9ba07b77da https://pubmed.ncbi.nlm.nih.gov/30352409 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....d4efe5200b4ca8112ac6ea9ba07b77da |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 20493614 |
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