ArticleThe Journal of clinical endocrinology and metabolism2022
Reassessment of Postural Stimulation Testing as a Simple Tool to Identify a Subgroup of Patients With Unilateral Primary Aldosteronism.
Article in The Journal of clinical endocrinology and metabolism, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.
- Tools to Predict Unilateral Primary Aldosteronism and Optimise Patient Selection for Adrenal Vein Sampling: A Systematic Review.Clinical endocrinology · 2025Pooled it
- Article
- Assessment, External Verification and Modification of Models in Diagnosing Primary Aldosteronism Subtypes.Journal of clinical hypertension (Greenwich, Conn.) · 2026Article
- Effect of a Prior Two-Hour Postural Test on Seated Saline Suppression Test Results in Patients Predominantly Evaluated for Adrenal Incidentalomas.Journal of clinical medicine · 2026Article
- Postural test to differentiate primary aldosteronism from low-renin hypertension: a retrospective single-center study.Journal of endocrinological investigation · 2026Article
- Comparisons of renin-angiotensin-aldosterone levels measured by chemical luminescence immunoassay and liquid chromatography-tandem mass spectrometry in hypertensive patients under different pathophysiological conditions.Journal of human hypertension · 2025Article
- Usefulness of the Upright Posture Test in the Diagnosis of Primary Aldosteronism.Journal of the Endocrine Society · 2024Article
- Simple standing test without furosemide is useful in the diagnosis of primary aldosteronism.Scientific reports · 2023Observational
- Renin, Aldosterone, and Cortisol in Pregnancy-Induced Hypertension.Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association · 2023Article
- Significance of computed tomography combined with postural stimulation test in predicting laterality of primary aldosteronism.BMC endocrine disorders · 2023Article
- Reassessment of Postural Stimulation Testing as a Simple Tool to Identify a Subgroup of Patients With Unilateral Primary Aldosteronism.The Journal of clinical endocrinology and metabolism · 2022Article
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
contextAdrenal vein sampling (AVS) represents the current diagnostic gold standard for differentiation between unilateral and bilateral primary aldosteronism (PA). Postural stimulation testing (PST) has been used to provide additional diagnostic information.
objectiveThis work aimed to evaluate the diagnostic utility of PST in the differential diagnosis of PA.
methodsThis cohort study was conducted at a single tertiary reference center. We analyzed 106 PST performed between 2008 and 2020. Diagnosis of PA and cause of PA were determined according to the Endocrine Society Clinical Practice Guideline, taking into account results of saline infusion testing, AVS, preoperative imaging, and outcome after medical or surgical treatment. The suggested cutoffs for the diagnosis of unilateral PA were revisited and optimized for high specificity using receiver operating characteristics (ROC) analysis.
resultsA total of 106 patients had confirmed PA (unilateral PA: n = 55, bilateral PA: n = 29, AVS unsuccessful/declined by patients: n = 22). Based on decreased aldosterone plasma concentration of 28% or more after 4 hours in the upright position, the PST showed a sensitivity of 36.4% at a specificity of 100% to identify unilateral disease (area under the curve [AUC] = 0.72; 95% CI, 0.62-0.83; P = .001). In patients with valid testing (drop of cortisol of 10% or more after 4 hours, n = 53) the sensitivity of PST rose to 51.4% at a specificity of 100% (AUC = 0.77; 95% CI, 0.65-0.90; P = .001).
conclusionThe high specificity of 100% for the detection of unilateral PA in patients with decreased aldosterone by at least 28% after 4 hours makes PST a simple, noninvasive contribution to subtype differentiation in PA.
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