Prospective Evaluation of Confirmatory Testing For Primary Aldosteronism

  • STATUS
    Recruiting
  • End date
    Mar 31, 2023
  • participants needed
    200
  • sponsor
    University of Calgary
Updated on 19 November 2021
hypertension
diuretic
renin
hyperaldosteronism
hypokalemia

Summary

This study is to evaluate the performance characteristics of the seated saline infusion test and the ultra low-dose ACTH stimulation test for the diagnosis of primary aldosteronism.

Description

This is a prospective study (with a target recruitment of 200 participants) designed to evaluate the performance characteristics of the seated saline infusion test and the ultra low-dose ACTH stimulation test for the diagnosis of primary aldosteronism, using disease-specific treatment response as a reference gold standard. Subjects consenting to study participation will undergo a standardized seated saline infusion test, followed by an ultra low-dose ACTH stimulation test. All participants also receive adrenal vein sampling. Individuals who have unilateral disease and desire surgery will receive adrenalectomy (as part of routine care) and the remaining subjects will receive medical treatment with a mineralocorticoid receptor antagonist. Response to targeted treatment will be considered the reference gold standard for the establishing the diagnosis of primary aldosteronism.

Details
Condition primary aldosteronism, primary hyperaldosteronism, Hyperaldosteronism, conn
Treatment Seated intravenous saline infusion test, Ultra low-dose ACTH stimulation test
Clinical Study IdentifierNCT04422756
SponsorUniversity of Calgary
Last Modified on19 November 2021

Eligibility

Yes No Not Sure

Inclusion Criteria

Individuals with hypertension
Individuals with an elevated screening adrenal renin ration (ARR)
Individuals with high probability features of primary aldosteronism (e.g., resistant hypertension, spontaneous or diuretic-induced hypokalemia, and/or an adrenal nodule) with clinical indications for adrenal vein sampling and surgery (if appropriate)

Exclusion Criteria

Individuals with chronic kidney disease (estimated glomerular filtration rate <40 mL/min/1.73m2)
Individuals with a history of heart failure, chronic edema, uncontrolled severe hypertension (systolic blood pressure >180 and/or diastolic blood pressure >110 mmHg), untreated hypokalemia, cortisol-secreting adrenal adenoma, and/or pheochromocytoma
Individual who previously received confirmatory testing
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