In:
Hypertension, Ovid Technologies (Wolters Kluwer Health), Vol. 70, No. suppl_1 ( 2017-09)
Abstract:
Introduction: There is a clinical need for an easy-to-use method to determine who should be screened for primary aldosteronism (PA). Objective: The aim of our study is to develop and validate a scoring system from clinical features and daily laboratory tests to select patients who should proceed to endocrinolgic examinations of PA from newly diagnosed hypertensives. Methods: A multivariate logistic regression analysis which entered possible PA markers, age 〈 40 years, female sex, moderate to severe hypertension, hypokalemia, serum Na + minus Cl - ≥ 40 mmol/L, serum uric acid ≤ 237.92 μmol/L (4.0 mg/dL), and urine pH (U-pH) ≥ 7.0 were undertaken in consecutive outpatients newly diagnosed hypertension. The diagnosis of PA was made by plasma aldosterone concentration-to-plasma renin activity ratio (ARR) ≥ 20 and at least one positive result in challenge tests. Results: In derivation study, 24 of 130 patients were diagnosed PA. The area under the receiver operating characteristic curve (AUC) for a logistic model incorporating all possible PA markers was 0.73 (95% CI: 0.61-0.85). Removing high U-pH, female sex, and hypokalemia from the full model decreased the AUC by 0.059, 0.035, and 0.011, respectively. We devised the diagnostic score for predicting possible PA, in which one point each was assigned to high U-pH, female sex and hypokalemia, and named it PFK score. The prevalence of PA in patients with 0, 1, 2, and 3 points were 11% (6 of 50), 14% (7 of 50), 42% (8 of 19), and 60% (3 of 5), respectively. In external validation datasets including patients already treated, 23 of 106 patients were diagnosed PA. AUC of PFK score was 0.73 (95% CI: 0.63-0.83), significantly higher than that of hypokalemia alone (0.53, 95% CI: 0.44-0.63, P 〈 0.01). Conclusion: We successfully developed the easy-to-use diagnostic score for predicting possible PA, PFK score which is superior to hypokalemia alone.
Type of Medium:
Online Resource
ISSN:
0194-911X
,
1524-4563
DOI:
10.1161/hyp.70.suppl_1.p398
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2017
detail.hit.zdb_id:
2094210-2
Permalink