ArticleEuropean journal of endocrinology2021
Confirmatory testing of primary aldosteronism with saline infusion test and LC-MS/MS.
Article in European journal of endocrinology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05959863 (LC-MS/MS-specific Cutoffs for Screening and Confirmatory Testing of Primary Aldosteronism), which is not on this map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
LC-MS/MS-specific Cutoffs for Screening and Confirmatory Testing of Primary Aldosteronism: A Multi-center Study
Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.
- Performance of Confirmatory Tests for Diagnosing Primary Aldosteronism: a Systematic Review and Meta-Analysis.Hypertension (Dallas, Tex. : 1979) · 2022Pooled it
- Liquid Chromatography-Tandem Mass Spectrometry Outperforms Radioimmunoassay in Guiding Surgical Decisions Based on Adrenal Venous Sampling in Primary Aldosteronism.Endocrinology and metabolism (Seoul, Korea) · 2025Article
- Resolution of paradoxical bilateral aldosterone suppression with mass spectrometry.European journal of endocrinology · 2025Article
- Investigating the cut-off values of captopril challenge test for primary aldosteronism using the novel chemiluminescent enzyme immunoassay method: a retrospective cohort study.Hypertension research : official journal of the Japanese Society of Hypertension · 2024Article
- Comparison of saline infusion test and captopril challenge test in the diagnosis of Chinese with primary aldosteronism in different age groups.Frontiers in endocrinology · 2024Observational
- Primary Aldosteronism: State-of-the-Art Review.American journal of hypertension · 2022Article
- Recalibrating Interpretations of Aldosterone Assays Across the Physiologic Range: Immunoassay and Liquid Chromatography-Tandem Mass Spectrometry Measurements Under Multiple Controlled Conditions.Journal of the Endocrine Society · 2022Article
- The Saline Infusion Test for Primary Aldosteronism: Implications of Immunoassay Inaccuracy.The Journal of clinical endocrinology and metabolism · 2022Article
- Reliability Analysis of a Functional Diagnostic Test for Primary Hyperaldosteronism Based on Data Analysis.Computational intelligence and neuroscience · 2022Article
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveSaline infusion testing (SIT) for confirmation of primary aldosteronism (PA) is based on impaired aldosterone suppression in PA compared to essential hypertension (EH). In the past, aldosterone was quantified using immunoassays (IA). Liquid chromatography tandem mass spectrometry (LC-MS/MS) is increasingly used in clinical routine. We aimed at a method-specific aldosterone threshold for the diagnosis of PA during SIT and explored the diagnostic utility of steroid panel analysis.
designRetrospective cohort study of 187 paired SIT samples (2009-2018). Diagnosis of PA (n = 103) and EH (n = 84) was established based on clinical routine workup without using LC-MS/MS values.
settingTertiary care center.
methodsLC-MS/MS using a commercial steroid panel. Receiver operator characteristics analysis was used to determine method-specific cut-offs using a positive predictive value (PPV) of 90% as criterion.
resultsAldosterone measured by IA was on average 31 ng/L higher than with LC-MS/MS. The cut-offs for PA confirmation were 54 ng/L for IA (sensitivity: 95%, 95% CI: 89.0-98.4; specificity: 87%, 95% CI: 77.8-93.3; area under the curve (AUC): 0.955, 95% CI: 0.924-0.986; PPV: 90%, 95% CI: 83.7-93.9) and 69 ng/L for LC-MS/MS (79%, 95% CI: 69.5-86.1; 89%, 95% CI: 80.6-95.0; 0.902, 95% CI: 0.857-0.947; 90%, 95% CI: 82.8-94.4). Other steroids did not improve SIT.
conclusionsAldosterone quantification with LC-MS/MS and IA yields comparable SIT-cut-offs. Lower AUC for LC-MS/MS is likely due to the spectrum of disease in PA and previous decision making based on IA results. Until data of a prospective trial with clinical endpoints are available, the suggested cut-off can be used in clinical routine.
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